BLOG: PrEP is for women too! 

Following a successful programme to reach more women with HIV PrEP, we asked Dr. David Rook, Specialty Registrar in Sexual Health and lead for the Axess PrEP for Women campaign, to tell us about why we did this, the urgent need to improve PrEP awareness and provision to women in Liverpool and its role in ending all new HIV cases by 2030.

What is PrEP? 

PrEP stands for pre-exposure prophylaxis. It is for people who don’t already have HIV but are at risk of getting it. PrEP is highly effective at reducing this risk. 

The rate of new HIV diagnoses in the UK is continuing to rise, with a large proportion of cases in heterosexual women. While HIV pre-exposure prophylaxis (PrEP) is over 99% effective at preventing HIV from sex, it is rarely used by women at risk. This trend is echoed by the women I see in my sexual health clinics, many of whom have never heard of PrEP or realised they could benefit from it. 

As a member of the ‘Fast-Track Cities’ network, Liverpool has seen significant successes in exceeding targets related to HIV testing, treatment, and viral suppression. The city is committed to meeting the government’s target to end all new HIV cases by 2030. However, PrEP awareness and provision among women remain low, highlighting a key opportunity to increase its availability and uptake. 

Barriers to PrEP for Women 
One of the main barriers to women using PrEP is a lack of awareness. Many women at risk of HIV do not realise they are at risk, and therefore don’t think PrEP is relevant to them. Furthermore, very few of the original PrEP research studies involved women, so less was initially known about how PrEP works for this group. 

Stigma and negative stereotypes are also significant barriers, preventing some women from engaging with sexual health services and HIV prevention. We aimed to remove this stigma by delivering an engaging and eye-catching campaign that promotes good health. 

The EmpowHERment Campaign 

This summer, Axess Sexual Health in Liverpool launched the ‘EmpowHERment’ campaign, a series of pilot interventions to promote PrEP to women and support the clinicians providing it. By showing that PrEP is just a regular part of looking after your sexual health—like contraception or having a smear test—we hope to normalise PrEP for as many people as possible. 

The campaign has been a hive of activity, with posters, online resources, and social media releases, even featuring PrEP advocate and reality TV star Dan Harry, who presented the BBC documentary HIV, PrEP and Me. 

In addition, our fantastic community outreach team has been pivotal in taking our message beyond the clinic and out to those most vulnerable and underserved within the local community. Regular staff training and engagement have ensured clinicians feel confident offering PrEP to women and having key conversations about whether PrEP is the right option for them. 

Looking Forward 

Through these measures, we hope to break down the barriers to PrEP provision for women and facilitate a safe and inclusive service that advocates for women and their right to access PrEP. We need to change the narrative so that women at risk of HIV know that PrEP is available to them too. 

Understanding why women don’t currently access PrEP and challenging perceptions about it are vital steps if we are to level the playing field and ensure all who need PrEP can receive it. 

Although it’s still early days, we have already seen our local offer and uptake rates among women increase since the campaign began. This is encouraging and demonstrates that with focused promotion to women and staff education on eligibility, we can make a real difference in PrEP provision—something that is long overdue. 

Here in Liverpool, we pride ourselves on our pioneering spirit, a true testament to the incredible people living and working here. By trying new ideas and concepts, we might reverse this trend and pave the way for other cities and regions to follow. 

I am confident that by working together, we will increase the uptake of PrEP and help eradicate HIV. 

Dr. David Rook 
Specialty Registrar, Axess Sexual Health