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HIV Prevention Strategies

PrEP

Pre-Exposure Prophylaxis (PrEP)is a preventive medication to protect you from contracting HIV. 
People who are HIV-negative can take PrEP to reduce their risk of getting HIV.  Many studies have confirmed that PrEP is more than 99% effective at preventing HIV transmission when taken as directed. 

People at risk of HIV are eligible for PrEP, including sexually active gay and bisexual men and transgender people, and anyone who has sexual partners of unknown HIV status, or from countries with a high incidence of HIV. 

Generic brand Emtricitabine/Tenofovir is the only PBS approved PrEP treatment in Australia. Find out more by visiting the AFAO site Get PrEP’D. 


Daily Dose, On Demand or Periodic?

Daily PrEP:PrEP can be taken as a daily dose so that you are protected against HIV transmission all the time. This option means whenever sex happens you have HIV prevention covered. Another benefit is that you can get fit PrEP into your daily routine to avoid missing a dose.

On-demand PrEP:

On-Demand PrEP describes how some people choose to only use PrEP when they know there is a chance they may be exposed to HIV for a short-term period. Also known at 2-1-1 PrEP, On-demand means using fewer pills at specific times over a few days. For example, if you need protection for one evening or a weekend, you can take PrEP before, during, and after this period only. The PrEP Guidelines recommend taking two tablets between 2 and 24 hours before your first sexual contact, and then one tablet daily after that. Continue to take one daily tablet for a minimum of 48hrs after your last sexual contact. This method may not be appropriate for transmen. For more detail about how PrEP on Demand works, check out these two websites: 

pan.org.au/how-to 

getprepd.org.au/how-to-take-prep/ 

Periodic PrEP: Periodic PrEP is similar to Daily PrEP, but you only take it for a limited time (like for a holiday or the Mardi Gras period). Periodic PrEP starts by taking two tablets between 2 and 24 hours before your first sexual contact, and then one tablet daily after that. Continue to take one daily tablet for a minimum of 48hrs after your last sexual contact. 

Talk to your doctor about which way will suit your lifestyle.


How Can I Get PrEP?

PrEP is available in Australia with a prescription. That prescription needs to come from a General Practitioner (GP) or at a sexual health clinic after a full sexual health screening. PrEP is available through the Pharmaceutical Benefits Scheme (PBS) for anyone with a Medicare card. For more information about what this means, please see the AFAO PrEP Factsheet. 

The screening will be repeated with every visit to check not only for HIV but also for any other sexually transmissible infections (STIs). You can find a doctor in your area to consult about PrEP by visiting the PAN website. Websites such as PrEPaccessNOW can also help people connect to pharmacies.


What If I Am Not Eligible For Medicare?

Personally importing PrEP is still an option.  Click here to find out more via ASHM and AFAO. PrEP can be purchased and imported through online pharmacies with a prescription. STRIP Clinic and Canberra Sexual Health Centre can provide information on self-importation, prescriptions, and help you to look after your health while on PrEP, along with regular sexual health check-ups. 

If you’re not sure whether you can afford PrEP, please contact us. You may be eligible for a PrEP coupon through the Green Cross Pharmacy partnership. More about this programhere.


Is PrEP For Me?

In Australia, sexually active gay and bisexual men, transgender people and heterosexual people with an HIV-positive partner who does not have an undetectable viral load are population groups that are at higher risk. If you are not using PrEP, and you think you are at high risk of HIV, you should see your doctor or visit a sexual health clinic to assess whether PrEP will benefit you. For more information, ASHM (Australian Sexual Health Medicine) has developed clinical guidelines to assist doctors in making decisions about prescribing PrEP. 


Do I Need To Use Condoms When On PrEP?

Condoms protect against more than HIV, providing users with safety from a number of other STIs. You should have an honest, open discussion with your sexual partner/s about sexual health, taking care of yourself and taking care of each other, and make a decision about protection you are both comfortable with. Regular sexual health testing is a great idea for anyone who is sexually active. To find out more about access to sexual health testing in the ACT, click here. 

If you would like to discuss if PrEP is for you, contact us on 02 6257 2855 or Canberra Sexual Health Centre on 02 6244 2184. 

 

PEP

PEP (Post-Exposure Prophylaxis) helps prevent HIV Infection after possible exposure.

If you think that you have been exposed to HIV, it is very important that you act sooner rather than later. PEP (Post-Exposure Prophylaxis) is a month-long course of drugs that help prevent HIV infection that is taken after a possible exposure to HIV. 

The sooner someone starts PEP, the better, but it must be started within 72 hours (3 days) after a possible exposure to HIV. 

If you think that you may have been exposed to HIV, PEP may help prevent acquiring HIV. The sooner someone starts PEP, the better, but it must be started within 72 hours (three days) after the possible HIV exposure incident. 


Reasons to take PEP may include:

  • Having receptive anal sex without a condom when you’re not using PrEP, with someone whose HIV status you do not know 
  • Having receptive anal sex without a condom with someone who is HIV positive and does not have an undetectable viral load 
  • A condom breaking or slipping during sex 
  • Sharing injecting equipment 

PEP is not a cure for HIV. PEP can prevent HIV from establishing itself in the body when a course of PEP is started within 72 hours after a possible exposure. 

Find out more about PEP at www.getpep.info 

You can access PEP from the Accident & Emergency Departments of Canberra Hospital and Calvary Hospital, and during business hours at the Canberra Sexual Health Centre. 

Please be aware that PEP is not a cure once HIV has established infection in the body. However, if taken within 72 hours of exposure to HIV, PEP can, in most cases, prevent HIV from establishing itself in the body. 

We encourage people to act as quickly as possible to access PEP. 

If you find that you need to access PEP more than once, you might want to consider PrEP. 

 

U = U

What Is “U equals U”?

When a person living with HIV is taking HIV medication, the virus will be suppressed to the point where there is not enough HIV in their blood for a test to measure. This is called an Undetectable Viral Load (UVL). When a person is living with an Undetectable Viral Load, they will experience greatly improved health outcomes and cannot transmit HIV to a partner who is HIV-negative. 

HIV positive people, health and community organisations often talk about this ground-breaking news using the simple phrase “Undetectable Equals Untransmissible” or U=U. 

 
  • U=U means a person living with HIV who has an undetectable viral load cannot pass on HIV to their sexual partners.
  • U=U has been confirmed by all the available research on the topic over the past 10 years. 
  • U= U has been endorsed throughout the world by public health and scientific bodies in the HIV field. In Australia it has been endorsed by the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM), the Australian Federation of AIDS Organisation (AFAO), and the National Association of People Living With HIV Australia (NAPWHA). Meridian has also endorsed this position. 

For more information about U=U, visit Undetectable = Untransmittable: A guide for clinicians 


For HIV Positive People:

The implications of U=U are highly significant. For many years, being HIV positive has carried stigma, mainly because the person with HIV being was perceived as a risk to others. Understanding U=U can greatly reduce anxiety about HIV transmission. It can empower people with HIV to be comfortable and confident to pursue a fulfilling sex life and secure relationships. Find out more: The Institute of Many