Would you take an HIV prevention pill if it was as easy as ordering Deliveroo?

You can now live a long and healthy life with HIV, thanks largely to medication that has turned it from a fatal infection and terminal illness into a chronic but manageable condition.

Antiretroviral therapy – the daily medication that stops the virus from multiplying and damaging the immune system, and that also suppresses the viral load, meaning it cannot be sexually transmitted to others – was first prescribed more than three decades ago. But it has been adapted in recent years into a preventative medication, a daily pill known as pre-exposure prophylaxis (or PrEP), prescribed to those at risk of HIV infection from sex or intravenous drug use.

It is the success of PrEP since its introduction in 2017 that has led to it being available free of charge at NHS sexual health clinics. Clinical trials have shown it to be 99 per cent effective in preventing HIV infection, which is even better than condoms. It also helped convince the Labour Party to declare in its election manifesto that the government will end all new cases of HIV by 2030.

However, figures published earlier this month by the UK Health Security Agency (UKHSA) suggest we’re not yet making the best use of this remarkable medicine.

While new HIV diagnoses in England fell by four per cent between 2023 and 2024 – from 3,169 to 3,043 – progress is uneven. PrEP is still mostly offered to gay and bisexual men, and much less so to heterosexual people at heightened risk, even though they now make up the majority of new HIV infections.

The drivers behind HIV transmissions are complex and track closely to issues of social exclusion, mental health and societal prejudice. But there are also humdrum, everyday barriers to HIV prevention that we’re not dealing with.

To access PrEP, most people in Britain still need to book an appointment at a sexual health clinic, ensure they attend (perhaps during working hours), and do so each time they need a new prescription. Underfunding over many years means that some patients wait weeks to be seen. Meanwhile, heterosexual people are still consistently overlooked for PrEP. For others, it’s simply too far – sometimes too expensive – to travel to a clinic.

In the new age of digital healthcare, there is little to justify this approach for many, if not the majority, of potential PrEP users.

The Elton John Aids Foundation recently launched a £1m pilot scheme across northeast London, where PrEP can be issued fully online and the pills – and requisite tests – delivered directly to your door or a local drop box. Early data indicates that the approach is popular among both long-time PrEP users and those recently initiated. Were it to be scaled up across England, it has the potential to save precious resources for sexual health clinics to care for people with more complex needs.

“Digital PrEP”, as this scheme has come to be known, breaks down more than just logistical barriers – it strikes at the heart of stigma. It is still widely believed that HIV is someone else’s problem, mainly affecting gay men, and that mindset makes straight men think twice before walking into a specialist clinic. And, for women, taking control of their sexual health too often comes with judgement attached. Meanwhile, others worry what their presence there might disclose about their sexuality – a fear that, tragically, still looms large for a great many.

Making PrEP available online means putting HIV prevention medicine straight into the hands of those who need it most – with hyper-tailored messaging that tackles lingering myths head-on, in a way that fits around people’s busy lives. Yes, we must normalise taking charge of our sexual health – and that includes walking through clinic doors when needed, whether it’s for the new gonorrhoea vaccine or routine check-ups. But showing up in person should never be the price of protection when modern testing and medicine can arrive quietly, directly, and safely – no stigma attached.

The fight against HIV and Aids, and the government’s disease prevention agenda at large, shouldn’t be about beating the odds; it should be about changing the odds. Making PrEP as easy to order as a Deliveroo meal (albeit one that requires an online health questionnaire and an easy, at-home test) makes it convenient and less stigmatising for people to use; it is our best shot at slashing new transmissions – and it honours the legacy handed to us by those who refused to accept a deadly epidemic as inevitable.

England continues to excel in HIV prevention, treatment and care, beating UNAids’s global “90-90-90” target – for 90 per cent of those with HIV to know their status, 90 per cent of those to be on antiretroviral therapy, and 90 of those being treated to have a suppressed viral load, making it untransmissable – for the sixth consecutive year: in England, 95 per cent of adults living with HIV are diagnosed, 99 per cent of those diagnosed are receiving treatment, and 98 per cent of those on treatment have suppressed viral loads. Deaths among people living with HIV also decreased by 14 per cent between 2023 and 2024.

However, major disparities remain. Black African heterosexual women and men have PrEP uptake rates of just 34.6 per cent and 36.4 cent respectively, compared with nearly 80 per cent among white gay and bisexual men. Half of Black African heterosexual adults are diagnosed late – 10 times more likely to die within a year than those diagnosed promptly. And young people aged 15-24 now have the lowest treatment rates (96 per cent) and the lowest viral suppression (91 per cent) in England.

If we are serious about ending new HIV transmissions by 2030, these gaps must be closed. Online PrEP access is not just a modern convenience – it is an equaliser.

Anne Aslett is the CEO of the Elton John Aids Foundation