PrEP For HIV Prevention
A once a day pill that keeps you HIV negative
As a guy who has sex with guys, you may have already heard about PrEP. Perhaps you already know a little about it and you’d like to know more, or perhaps you don’t know much about it at all.
Either way, PrEP is an exciting biomedical development that is already playing a vital role in our efforts to end HIV by 2020, and since being listed on the PBS (Pharmaceutical Benefits Scheme), just about anyone can now get on it!
What is PrEP and why should I take it?
PrEP is an acronym that stands for pre-exposure prophylaxis. It involves HIV negative people taking antiretroviral drugs to protect them and prevent HIV infection – just one tablet a day.
Unlike post-exposure prophylaxis (PEP), which is taken after a potential exposure to HIV, PrEP is taken on an ongoing basis before potentially being exposed to HIV. Some would say it’s similar to ‘the pill’ that women take to prevent unplanned pregnancy.
Studies from around the world have shown that when PrEP is taken daily it is highly effective at preventing HIV. It allows you to be in control of your HIV status, gives you around-the-clock protection against HIV and can relieve stress and anxiety that can be associated with sex.
Neg or poz, we all share responsibility for HIV prevention. With PrEP, neg guys have an additional tool they can use to proactively be in control of their HIV status. When PrEP is in the equation, poz guys can be confident that their partners are well protected.
Who is PrEP for?
PrEP is recommended for people who are considered at risk of getting HIV. You are at risk if you:
- Are a man (cis or trans) who has anal sex with other men and does not always use a condom
- Have a heterosexual partner who has HIV and you want to have a baby
- Have a partner who is HIV positive but has not achieved an undetectable viral load, and you don’t always use a condom
To take PrEP you must be HIV negative and a HIV test should always be performed before you start taking PrEP, your PrEP presciber will go through this with you at your first appointment.
While PrEP is effective in protecting you from HIV, PrEP does not protect you from sexually transmitted infections (STIs). Anyone taking PrEP should test at least four times a year for STIs and consider even more STI check-ups if they are having a lot of sex without condoms. A full screen should include chlamydia, gonorrhoea and syphilis, and can also be done when you visit your PrEP prescriber.
Where and how can I access PrEP?
Access PrEP through the Australian healthcare system
If you are an Australian resident with a current Medicare card you can access PrEP through the PBS at a subsidised cost. This means any doctor or general practitioner can write a script for PrEP which you can take to any pharmacy for dispensing (collection). Keep in mind you may have to pay for your doctor’s visit if it’s not a bulk billing service.
Access PrEP through personal importation
If you are not able to access PrEP through Medicare, another option is to purchase a generic version of the drug from a reliable overseas supplier. You still require a script from a doctor before ordering online. There are multiple suppliers who export PrEP into Australia at a range of costs. Visit the ‘PrEP Access Now’ website for more information.
How much does PrEP cost through the PBS?
Anyone with a Medicare card and a script from their GP will have to make a PBS co-payment at the pharmacy when collecting their PrEP, which is the same for all other medications accessed via the PBS. From 1 January 2019 the maximum cost per script increased from $39.50 to $40.30, while for concessional patients the cost increased from $6.40 to $6.50 per script.
More frequently asked questions about PrEP
I’ve heard PrEP is now on the PBS. What does that mean?
PrEP is now available on the PBS, making it available at any pharmacy, at an affordable price. For people interested in starting PrEP, you should speak to a doctor – either at a general practice or sexual health clinic – to see if you are eligible. If eligible, you will receive a script for PrEP that you can collect from any pharmacy, or order from an online pharmacy.
When does EPIC-NSW end?
New enrolments for EPIC-NSW ceased on 30 April 2018. If you are already on the study, the timing of when you enrolled will determine when you receive your last supply of free study PrEP. These dates vary, so it is best to gain confirmation from your PrEP prescriber at the clinic you currently attend.
I’m on the EPIC-NSW study, what does that mean for me?
The timing of when you enrolled into EPIC-NSW will determine when you receive your last supply of free study PrEP.
At your final appointment, most EPIC-NSW participants should receive three months’ supply of free study PrEP. It is important that you make any necessary arrangements early, such as finding a new doctor to issue your script or finding a pharmacy to collect your PrEP from, to ensure you have a continued supply of PrEP.
Your PrEP prescriber will go through this information and discuss these arrangements with you during your final appointment.
How much does PrEP cost?
From 1 January 2019 the maximum cost per script (or one month’s supply) for those who have access to Medicare increased from $39.50 to $40.30, while for concessional patients the cost increased from $6.40 to $6.50 per script. Each time you see your doctor you should receive one script and two repeats (three months’ supply in total).
There may be some additional costs for the appointment, depending on if your doctor offers bulk-billing through Medicare.
Any doctor can now prescribe PrEP. When choosing a doctor, it is important you find someone who you feel comfortable discussing your sexual history with as this is required for the eligibility and ongoing screening for those who take PrEP.
If you’re searching for a doctor who can prescribe PrEP for you or want to talk to someone about PrEP before you see your doctor, you can call the NSW Sexual Health Info Link on 1800 451 624.
Can anyone get PrEP now?
PrEP is now available for people who are at risk of acquiring HIV.
For gay men the risk criteria includes having condomless sex with a partner who doesn’t know their HIV status, having a regular partner with HIV who is not on treatment, having a recent STI in your arse such as gonorrhoea or chlamydia or if you occasionally party and play.
If you answered yes to any of these criteria, you should consider taking PrEP, or if you are unsure, speak with your doctor
There may be cases where someone can be prescribed PrEP without meeting these criteria, but this will require a discussion with a doctor.
I’m currently importing PrEP from overseas, what does that mean for me?
If you are currently importing PrEP, you have two options. You can continue to fill your script online and import generic PrEP via an online supplier. Or if you are eligible for Medicare, you can fill your script at a pharmacy for the subsidised price.
Can I continue to see my EPIC-NSW PrEP provider after I finish with EPIC-NSW?
Yes. You can continue to see your current PrEP prescriber at the clinical site you currently visit, whether this is a GP or sexual health clinic. However in some cases, there may be a consultation fee for these appointments.
Alternatively, you have the choice to find another doctor who will prescribe you PrEP. If you’re searching for a doctor who can prescribe PrEP for you or want to talk to someone about PrEP before you see a doctor, you can call the NSW Sexual Health Info Link on 1800 451 624.
I am interested in taking PrEP, what do I need to do?
If you are thinking about starting PrEP, you will need to make an appointment with a doctor or sexual health clinic. During your first appointment they will discuss your eligibility for PrEP, complete the required testing for HIV and STIs, and check your kidney function.
Once you have completed the required testing, you will be given a script which you can collect from a pharmacy. It’s important to remember that PrEP is more than just a pill; it is a program which requires regular doctor visits and HIV and STI testing every three months. You will also need to make a follow-up appointment in one month for another HIV test. After that, you will need an appointment every three months to keep getting your prescription.
I don’t have Medicare, what does that mean for me?
If you don’t have access to Medicare, you will not be eligible to receive subsidised PrEP via the PBS. You can access PrEP via personal importation which can be an affordable alternative. Many overseas importation options offer generic PrEP at a price comparable to subsidised PrEP through the PBS. You will still need a script from an Australian doctor and there may be a cost associated with your appointment or required testing.
To access PrEP via personal importation, we recommend visiting the PrEPAccessNow website pan.org.au.
I have heard about on-demand PrEP – what does this mean?
While PrEP is generally recommended to be taken daily, it can also be effective when used on-demand. On demand PrEP can suit people who infrequently have sex without condoms or have sex without condoms for a short period of time (while traveling, during party season or a big weekend).
On demand PrEP requires taking less pills at specific intervals before and after sex. If you think on demand PrEP is more suitable for you, you should talk with your doctor.
Know the Facts about PrEP
You may have lots of questions about PrEP, these factsheets in the following languages below answer some of the most common ones asked:
- Arabic (2mb)
- Chinese (Simplified) (6mb)
- Chinese (Traditional) (2mb)
- English (2mb)
- Indonesian (2mb)
- Portuguese (2mb)
- Spanish (2mb)
- Thai (2mb)
- Vietnamese (2mb)
If you would like to speak to someone in your own language, call the Translating and Interpreting Service (TIS) on 131 450 to ask for an interpreter and then ask them to call the NSW Sexual Health Infolink on 1800 451 624.
View the PrEP information booklet here.