Australasian HIV nursing organisations
Australian Sexual Health and HIV Nurses Association (ASHHNA) Inc Australian and New Zealand Association of Nurses in AIDS Care (ANZANAC) via Facebook
Guidelines
References
Crock E, Butwilowsky J. The HIV resource nurse at the Royal District Nursing Service (Melbourne): making a difference for people living with HIV/AIDS in the community. Australian Journal of Primary Health 2006; 12(2), pp. 83-89. Hopwood M, Newman C, Persson A, Watts I, de Wit J., Reynolds R., . . . Kidd, M. Expert perspectives …
Biomedical HIV prevention
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 …
Non-occupational postexposure prophylaxis (NPEP)
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 »
Time to first dose
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 …
Incomplete adherence
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 …
Continued risk
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 …
HIV pre-exposure prophylaxis (PrEP)
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 …
Nurses’ roles in PrEP
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 …
Conclusion
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.