People who are homeless and at risk of HIV supported with UK-first mobile PrEP initiative

23rd February 2021

A team of sexual health nurses have been taking their service to the streets of Glasgow with a specially designed van to provide support to people who are experiencing homelessness during the pandemic.

The pioneering programme, run by NHS Greater Glasgow and Clyde, is designed to prevent HIV infection among people who are homeless and who inject drug by delivering assessments for HIV PrEP – a simple treatment which can prevent those at high risk of HIV from acquiring the infection. Those at risk need to take just one pill a day.

“We started the service before COVID hit, but when it did, we soon realised that the restrictions presented an opportunity for us,” explained Dr Becky Metcalfe, a Consultant in Sexual Health & HIV at the Sandyford Clinic in Glasgow.

“Those who were homeless were being housed in hotels and that meant there was a chance we could reach them easier. We borrowed a van and hit the streets and were able to get to people.”

The team have been working to identify those who may be more at risk of infection through sexual contact. This, coupled with increased risk from injecting drug use, means that many of the 50 people assessed as part of the project are at higher risk of HIV infection.

Becky added: “This is a group that don’t normally come to us for help and that has been disproportionately impacted by both COVID and complexities such as addiction, homelessness, deprivation and mental health issues. It’s a very vulnerable group.

“We decided that rather than pull back, we would do more outreach. The response has been really positive. There’s been a significant HIV outbreak across the homeless population in Glasgow and having more people engaged in this preventative measure will help to tackle that.”

One of those who has benefited most has been Colin. The 28-year-old said it’s one less thing to worry about. “Sometimes I have so much going on that I forget to care about myself,” he said.

“PrEP was definitely a positive thing for me. I was putting myself at risk of HIV. The nurses helped me to get on it and then came to see me every couple of weeks to make sure I was ok. Getting tested all the time and being negative made me feel happier.”

Colin has had regular contact with some of the sexual health and HIV prevention outreach nurses, including Lynsey Boyd. She said: “It might be just a pill a day but it’s so much more than that,” She added.

“By engaging with our teams, we can signpost them to other services that can help them to deal with the many issues impacting on their lives and that’s a big win for everyone.”

The team provide sexual health screening, tests for blood borne viruses, free contraception and support to men and women who may have been victims of sexual assault. As part of drug harm reduction work, the team also distribute clean injecting equipment and naloxone – a medicine that can save the life of someone who overdoses on opioids, such as heroin or methadone.

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