John McAllister: St. Vincent’s Hospital, Sydney Revised and updated by Cherie Bennett Year Updated: 2024 Summary This chapter describes biomedical HIV prevention technologies in the Australian setting, evidence for their effectiveness, and the settings in which they can be used. It discusses nurses ‘roles in the implementation of biomedical prevention, guidelines and education. Introduction Non-occupational …
NPEP has been in wide-spread use in Australia since 1999 and is recommended by the Australian Government’s Department of Health and Ageing.[11] The Australian National NPEP guidelines recommend 28 days of ART (at prescriber’s discretion) with two or three drugs for an HIV transmission risk event of ≥ 1: 15,000. Australian men who have sex with …
Non-occupational postexposure prophylaxis (NPEP) Read More »
NPEP appears to be most effective when administered as soon as possible after exposure. In macaque monkeys, tenofovir initiated within 24 hours of a simian immunodeficiency virus (SIV) challenge provided 100% protection from infection vs 50% and 25% when initiated at 48 and 72 hours, respectively.[14] In seven human cases of seroconversion following NPEP, the …
Intolerable side-effects result in many clients failing to complete the prescribed course of NPEP. In a meta-analysis of PEP adherence, completion rates were 57% overall and 67% in MSM.[15] Toxicity driven discontinuation was commoner with three-drug regimens than with two-drug regimens (2% vs 9% respectively).[16] The World Health Organization (WHO) recommends that three antiretroviral drugs be …
NPEP use is a good indicator of future HIV risk and acquisition. Australian men who have sex with men who have ever used NPEP are around three times more likely to eventually acquire HIV infection when compared to men who had never used NPEP.[22] This heightened risk is less about drug failure and more about inability …
Up to 1:8 Australian men who have sex with men has HIV infection.[23] High levels of adherence to daily co-formulated TDF/FTC has been shown to be highly effective at preventing HIV infection in populations at high risk of HIV acquisition (Table 11).[24] It is estimated that 20% of gay men in Sydney are now taking …
PrEP use in Australia as part of and individual and population HIV risk reduction strategy is now wide-spread. Nurses have an important role to play (Table 15). Access to PrEP is crucial to realising its benefits. Nurses should be aware of those not currently benefiting from PrEP (younger men and those born overseas and without …
Antiretroviral therapy as prevention is currently front and centre stage. Nurses have a key role in service provision, education, support, and innovative research as NPEP and now PrEP assume a more prominent role in HIV prevention.
1. Remis RS, Alary M, Liu J, Kaul R, Palmer RWH. HIV transmission among men who have sex with men due to condom failure. PLOS ONE 2014; 9: e107540. 2. ACSA. Clinical Supervision: A Working Definition. ACSA Definitions Report. Forest Lake, Qld, 2014. 3. Cardo DM, Culver DH, Ciesielski CA, et al. A case-control study …
Developing a sustainable HIV, Viral Hepatitis and Sexual Health Workforce
Acknowledgement of Country
We pay our respects to the Aboriginal and Torres Strait Islander peoples of the past, present, and future, including the Gadigal peoples (Sydney office), the Turrbal and Jagera/Yuggera peoples (Brisbane office), and all First Nations people of the nations where we live and work.
ASHM Health | ABN 48 264 545 457 | CFN 17788 | Copyright © 2024 ASHM