HIV diagnoses fall as Australians embrace pre-exposure prophylaxis but challenges remain

HIV prevention in Australia has been revolutionised in the past few years by pre-exposure prophylaxis (PrEP) with antiretroviral medicines.

In an editorial in the December edition of Australian Prescriber, Senior researcher and Sexual health physician Dr Nicholas Medland and Program head Professor Andrew Grulich at the University of New South Wales’ Kirby Institute say that Australia is a global leader in the roll-out of PrEP to gay and bisexual men and this should help eliminate HIV transmission

“Patients may be protected from HIV by taking one tablet every day. The effects of this preventative medicine have been dramatic,” said Professor Grulich.

“In New South Wales, where PrEP has most widely been taken up, it has been associated with a rapid decline in diagnoses of HIV. A decline in newly diagnosed cases has also now been seen right around Australia.

“This treatment has only had the early success that it has as a result of many different factors, including it being subsidised through the Pharmaceutical Benefits Scheme. Clinicians are ready and keen to prescribe, the community is motivated to take it, and government and academia have been willing and able to contribute.

“Importantly though, we’re now noticing some new inequalities and at-risk groups, particularly men who were born overseas and specifically men who have sex with men who may be newly arrived in Australia and may not be eligible for Medicare because of their visa status.

“We encourage anyone who could be at risk, particularly men who have sex with men, to talk to their doctor about testing for HIV and sexually transmitted infections (STIs). Your doctor can treat STIs, recommend safe sex practices to prevent them, and discuss whether PrEP to prevent HIV infection may be suitable for you,” said Professor Grulich.

Read the editorial in Australian Prescriber.

A separate article in this edition of Australian Prescriber looks in more detail at prescribing PrEP for HIV and provides details for clinicians about how and when to prescribe the treatment, how effective it is, and possible adverse effects.

     

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