Nearly a third of people in Cornwall who have been identified with a need for PrEP – an HIV preventative drug – do not have a prescription, figures show.
Sexual health charity the Terrence Higgins Trust said PrEP services and HIV testing must be made more accessible to meet the Government's goal of eliminating new HIV transmissions by 2030.
PrEP is a drug taken either daily or before and after sex that can block HIV if it gets into the body, which is available for free through sexual health clinics.
Those eligible for the drug include men and trans women who are HIV negative and who have sex with men, and people whose partner who is HIV positive and is not virally suppressed. Eligibility also extends to those who have partners from parts of the world where the virus is common, and to sex workers.
For the first time, UK Health Security Agency figures show that 282 people were identified with a need for the drug in Cornwall, and 193 (68%) of them had a prescription in 2021.
This is above the level across the South West where 2,837 people used PrEP – 63% of those in need of it.
Kat Smithson, National AIDS Trust director of policy, said "too many" people who want PrEP are struggling to get it as sexual health services are increasingly under pressure and underfunded.
Ms Smithson added: “As well as a need for investment to engage new groups with PrEP, access in community settings, such as pharmacies and GPs, need to be leveraged to increase its reach."
Overall in England, nearly 27,000 of the 88,000 people (70%) identified with a need for the HIV preventative drug did not have a prescription for it.
The Terrence Higgins Trust, which is currently running National HIV Testing Week's "It Starts With Me" campaign, said PrEP has been a "game changer" for HIV prevention, but has so far only men who have sex with men.
The most recent data shows the primary group in need of PrEP across the South West were gay, bisexual and other men who have sex with men – accounting for 78% of those advised to take it.
Ian Green, chief executive of the charity, said the drug should be made available through primary care settings to reach those who do not usually attend sexual health clinics, particularly women.Mr Green added HIV testing also plays a fundamental role in reducing new transmissions. He said: "HIV testing rates must quickly return to pre-Covid levels and then expanded to get on track to end the Government’s goal of ending new HIV cases by 2030."
The trust is currently raising awareness alongside the Department of Health of its free HIV testing kits as part of National HIV Testing Week.
Separate UKHSA figures show 1,682 of those eligible for HIV testing (27%) in Cornwall were tested during 2021 when pandemic restrictions impacted services – below the national testing coverage of 46%.
Dr Alison Brown, UKHSA interim head of HIV surveillance, said: “We continue to make progress towards ending HIV transmission in England through reductions in the number of people living with undiagnosed HIV infection and increased access to PrEP. However, the COVID-19 pandemic has slowed momentum in HIV testing among heterosexuals and engagement in HIV care for those already living with HIV.
"Addressing these inequalities, ramping up testing to pre-pandemic levels and getting people started on HIV treatment earlier will all be crucial to ending HIV transmission in England by 2030.
“No matter your gender or sexual orientation, using condoms, using PrEP if advised, getting tested for HIV and treated if positive, remain vital in protecting your health and that of your partners,” Dr Brown added.