PrEP Pre-Exposure Prophylaxis

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At MSHC and Alfred Health, PrEP is also known as HIV Integrated treatment Prevention or HIP.
PrEP is "pre-exposure prophylaxis" for HIV. The goal of PrEP is to prevent HIV infection if you are exposed to HIV. This is done by taking a pill every day called Truvada®. Truvada contains two HIV medications, and is one of the drugs that is used to treat HIV, in HIV infected individuals. Taking daily Truvada® has been approved by the Food and Drug Administration in the United States since July 2012 for HIV prevention.

Is PrEP for me?

PrEP is suitable for you, if you are at high risk of HIV infection, this includes:

  • If you are a man who has sex with men without a condom. This is especially important if you have a sex partner who has HIV infection or is at high risk of HIV. 
  • If your partner injects drugs or is having sex with other people.
Is PrEP covered under Medicare?

No. Truvada® is currently not licensed by the Medicare Pharmaceutical Benefits Scheme for use as PrEP in Australia. However, prescriptions for Truvada® may still be issued for the purposes of PrEP.

Is PrEP effective?

Several studies have shown that PrEP reduced the risk of getting HIV infection. Men who have sex with men and who were given PrEP medication were 44 percent overall less likely to get HIV infection compared to those who took no PrEP medication. Those who took the pill more regularly had a reduced risk of HIV infection by 73 per cent or more, and up to 92 per cent for some. More information on the details of the studies can be found at http://www.cdc.gov/hiv/prep

Is PrEP safe? What are the side effects?

The clinical trials also provided safety information on PrEP. Some people in the trials had early side-effects such as an upset stomach, loss of appetite and headaches, but these where mild and usually went away within the first month. No serious side-effects were observed. A small proportion of people taking Truvada® develop kidney damage so it is very important you have kidney tests every three months.

What do I have to do?

If you are interested in PrEP, speak to your doctor to see if you are suitable. If you are likely to benefit from PrEP, blood tests to assess your kidney and liver function, in addition to an HIV test, will be done. You will then be given an appointment at our PrEP clinic where a detailed assessment of your suitability and whether you might benefit from PrEP, and your tests to ensure the PrEP is safe for you will be reviewed. Once you have met the eligibility criteria and want to start PrEP, you will be given a prescription. Details on how to obtain the medication are given at the end of this information sheet.

Taking PrEP medicines will require you to follow up regularly with your doctor. You will have blood tests for HIV and tests to see if your body is reacting well to the medication. You will also receive counselling to reduce the risk of acquiring HIV. You should take your medicine every day as prescribed, and your doctor will advise you about ways to help you take it regularly so that it stands the best chance to help you avoid HIV infection. Tell your doctor if you are having trouble remembering to take your medicine or if you want to stop PrEP. 

Does PrEP protect me against other Sexually Transmitted Infections (STIs)?

No, PrEP does not protect you against other STIs like syphilis or gonorrhoea. If you have started taking PrEP, it is important for you to return for regular STI screening.

I have heard about taking PrEP "as needed" instead of daily - will that be as effective?

Results from the IPERGAY study, where PrEP was only taken for short periods just before and after having sex, do not conclusively recommend taking PrEP on an "as needed" basis. Daily doses of PrEP medication are the best way to protect your self.

How long do I need to be on PrEP?

You should discuss this with your doctor. There are several reasons that people stop taking PrEP. If your risk of getting HIV infections becomes low because of changes that occur in your life, you may want to stop taking PrEP. If you find that you don't want to take a pill every day or often forget to take your pills, other way of protecting yourself from HIV infection may work better for you. If you have side effects from the medication that are interfering with your life, or if blood tests show that your body is reacting to PrEP in unsafe ways, your doctor may stop prescribing PrEP for you.

Are there any alternatives to PrEP?

Depending on your risk factors, you may be more suitable for other HIV prevention methods like PEP (Post Exposure Prophylaxis) or safer sex strategies.

How do I get the PrEP medication?

PrEP is available via clinical studies that are running in each Australian state. Generic PrEP can be purchased online in consultation with your doctor.
See www.prepdforchange.com/how-to-get-prep for more information.

DISCLAIMER:
This fact sheet is designed to provide you with information on PrEP. It is not intended to replace the need for a consultation with your doctor. All clients are strongly advised to check with their doctor about any specific questions or concerns they may have. Every effort has been taken to ensure that the information in this pamphlet is correct at the time of printing.
Last Updated December 2017