Over the past few years, there have been some important new developments in the prevention of HIV infection. In particular, there is now a tablet that you can take daily to reduce your risk of becoming infected if exposed to HIV. This type of HIV-prevention is called pre-exposure prophylaxis or PrEP.
What is PrEP?
PrEP is an anti-HIV medication taken by a person who does not have HIV to lower their risk of infection. In Australia, the brand name of the drug used for PrEP is Truvada.
Truvada is a tablet that combines two active chemicals – tenofovir disoproxil fumarate and emtricitabine (tenofovir-emtricitabine).
Although similar sounding, PrEP and PEP (post-exposure prophylaxis) should not be confused. PrEP is taken by people who don’t have HIV to prevent infection. PEP is a short course of anti-HIV medications taken by someone who might have been exposed to HIV, with the aim of preventing infection.
For more information, visit the get PEP website.
Who should consider taking PrEP?
You should consider taking PrEP if you are at high risk of being exposed to HIV. People at high risk of becoming infected by HIV include:
- gay and other homosexually active men who don’t use condoms
- drug users who share injecting equipment
- men and women who have sex with drug users without condoms
- men and women whose partners have HIV.
If you fall into one of these categories, you might want to talk to your doctor about PrEP. Your doctor will need to assess your HIV status and risk of infection and also discuss with you the possible side effects.
Effectiveness of PrEP
PrEP lowers the risk of infection with HIV if you take it every day, starting before exposure to the virus.
Note that if you are already infected with HIV, taking PrEP does not reduce the risk of transferring the virus to other people through sexual contact or blood.
Where can I get PrEP?
It is important to talk to your doctor first about the options, as well as about the risks and benefits of taking PrEP.
PrEP can be obtained:
- with a prescription for Truvada from your doctor
- by participation in a clinical trial (see below)
- with a prescription for a generic form of Truvada from your doctor.
Truvada is not yet available on the Pharmaceutical Benefits Scheme (PBS) so it is very expensive. Your doctor will be able to advise you on how to obtain the generic form of the medicine, including from overseas via the internet.
The Australian Federation of Aids Organisations (AFAO) website has more on obtaining PrEP from overseas suppliers.
PrEP clinical trials
Researchers are seeking participants for PrEP clinical trials in some parts of Australia. You may be able to participate if you are at high risk of acquiring HIV and you meet the eligibility criteria of the study.
The trials will subsidise the costs involved with PrEP but there may be some out-of-pocket expenses. You may be asked to register with a waiting list.
Clinical trials are currently recruiting in:
- New South Wales via the EPIC-NSW PrEP trial
- Queensland via the QPrePd study
- Victoria via the PrEPX study
- South Australia via the PrEPX-SA study
- Western Australia via PrEPIT-WA.
If you are not able to access a trial, but think you may benefit from PrEP, you should talk to your doctor or visit a sexual health clinic.
Tenofovir and emtricitabine have been approved by Australia's Therapeutic Goods Administration (TGA) for the treatment of established HIV infection and for PrEP. However, because Truvada is not yet available on the Pharmaceutical Benefits Scheme (PBS), PrEP is expensive.
In 2016, one year's supply cost around $10,000. Generic PrEP is much cheaper.
Many HIV advocacy and support organisations are seeking to have PrEP drugs listed on the PBS.
For more information about PrEP and Truvada, visit NPS Medicinewise.
Last reviewed: July 2017