10 Years of PrEP in Australia
05 Sep 2024
In 2014, Australia welcomed pre-exposure prophylaxis (PrEP) into the toolkit for HIV prevention. Melbourne in particular became one of the fastest adopters of PrEP in the world. In fact, according to last year’s Melbourne Gay Community Periodic Survey conducted by the Centre for Social Research in Health at UNSW, nearly half (49.4%) of non-HIV-positive participants reported using PrEP in the six months prior to the survey. That number jumps to 77.2% amongst those guys who reported not using condoms during anal sex. As news has emerged of PrEP supply shortages in Australia, it’s worth taking stock of some of the lessons we’ve learned from the past decade.
MORE THAN ONE WAY TO PrEP
While PrEP was initially introduced in Australia as a daily medication to prevent HIV, there are other ways to take PrEP. On-Demand PrEP is increasing in popularity, especially for cisgender guys who are not having sex every day. On-Demand PrEP is as effective as Daily PrEP, but one of the advantages is that you potentially go through fewer pills – making your limited supply last longer. The team at Emen8 have produced a number of articles to help guys understand On-Demand PrEP and compare On-Demand PrEP vs Daily. They’ve even produced a PrEP Selector Tool that can assist you in deciding what PrEP option best suits your lifestyle and needs. If in doubt, have a conversation with your trusted sexual health clinician, GP, or PrEP prescriber.
MAILED IT!
Prior to Australia adding PrEP to the Pharmaceutical Benefits Scheme (PBS) in April 2018, many guys were getting their supply via ‘personal importation’ – buying online via pharmacies based overseas. Today, many people who are ineligible for Medicare use this process. If you are unfamiliar with importation, it’s easy and often cheaper than purchasing PrEP from a pharmacy here in Australia.
You will need to ask your doctor for a physical script if they typically provide a digital prescription or eScript, and you will need to allow for shipping times.
If you’re still a bit unsure of about accessing PrEP by buying it from overseas, PrEP Access Now (PAN) has been helping folks navigate this process in Australia for years, and they’re still going strong. For many folks, this process is the simplest solution when PrEP supplies are running low.
THE PREVENTION TOOLKIT
At no point in history has there ever been so many ways to prevent HIV. Condoms have been a mainstay of HIV prevention for the last 40 years, and they continue to be a readily available and affordable option for HIV and STI prevention. Alongside condoms, we have had post-exposure prophylaxis or PEP in Australia for decades. Unlike PrEP, PEP is a four-week course of HIV treatment taken if you think you have been exposed to HIV in the last 72 hours. PEP is accessible via the emergency department at most public hospitals and sexual health clinics across Australia. The GetPEP website is a great resource for finding your nearest location to access PEP.
But perhaps one of the biggest developments in the past decade has been the emergence of UVL or Undetectable Viral Load. When someone living with HIV is on effective treatment, the level of virus in their system is greatly reduced. An undetectable viral load occurs when the amount of HIV in someone’s system is reduced to incredibly low levels that it practically becomes ‘undetectable’. Research has shown that a HIV-positive person who has an undetectable viral load has zero (yes ZERO) chance of passing on HIV to their partners. Undetectable = Untransmissable or U=U. UVL is currently the most effective way to prevent HIV transmission.
If it’s been a minute since you considered all the ways to prevent HIV, head over to the What Works website for a quick refresher.
REMAIN CALM AND CARRY ON
Hearing about a PrEP shortage may raise alarm bells, but there is a high likelihood the issue will be resolved in the coming weeks. You may see chemists limit how much of your prescription they’ll fill in the first instance and you may need to return to get the rest of your supply when they have more in stock. Plus, the various manufacturers of PrEP will also be looking at ways that can meet the demand here in Australia. If the last ten years of PrEP in Australia has taught us anything, it’s that our communities are resourceful and savvy when it comes to looking after their sexual health.