References
Kirby HIV in Australia: annual surveillance short report 2018. Sydney: Kirby Institute, UNSW Sydney;2018. NSW Ministry of NSW HIV Strategy 2016–2020 Quarter 1 2019. Data Report. Available at: https://www.health.nsw.gov.au/endinghiv/Publications/q1-2019-nsw-hiv-data-report.pdf (lastaccessed 2 September 2019). Queensland Pre-exposure Prophylaxis Demonstration Project Expansion (QPrEPd) Monitoring and EvaluationAnnual Report Number 1 Available at: https://www.comeprepd.info/wp-content/ uploads/2018/04/qprepd-first-report.pdfaccessed September 10th 2019 (last accessed 11 September […]
Adolescent minors
As a part of primary health care, HIV screening should be discussed with all adolescents who are sexually active, or have a history of injecting drug use. Parental or guardian involvement in an adolescent’s health care is often desirable, but is sometimes contraindicated for the safety of the adolescent, and can compromise full disclosure. Clinicians […]
Patients with chronic active HBV infection
PrEP and Chronic Hepatitis B The risk of HBV infection is significantly reduced in people who use TD*/FTC for HIV PrEP, with or without HBV vaccination due to these drugs having dual HIV and Hepatitis B activity.5-7 All people who test positive for hepatitis B surface antigen (HBsAg) should be evaluated for the need for […]
Patients with chronic renal failure
Patients without HIV infection and with established chronic renal failure, e.g. with estimated glomerular filtration rate (eGFR) that is stably less than 60 mL/min/1.73 m2 should not be prescribed PrEP. The only PrEP regimen proven effective to date and approved by the TGA is TD*/FTC, which is not indicated for those with chronic renal failure […]
Breastfeeding
Although experience with PrEP during breastfeeding is lacking, there is substantial experience with the use of TD*/FTC during the breastfeeding period by HIV-positive women taking TD*/FTC based antiretroviral therapy. TD* and FTC are secreted in breast milk, although at much lower concentrations (0.3 and 2%, respectively), of the levels achieved with the doses recommended for […]
Women taking PrEP during conception, pregnancy and breastfeeding
Conception in serodiscordant couples Women without HIV infection who have sexual partners with documented HIV infection are at risk of HIV acquisition during natural attempts to conceive (i.e. without a condom) if their HIV-positive partner has a detectable or variably detectable plasma viral load. Providers should discuss with their patients the available information about the […]
Transgender men
There are very few data regarding PrEP knowledge, acceptability and use in transgender men. Nor are there data regarding whether GAHT influences PrEP drug levels or vice versa in transgender men. A 2016 review of HIV and STI research undertaken in transgender men was unable to find any data on the use of PrEP in […]
Transgender women
Transgender women have a high prevalence of HIV infection 8 and experience high HIV incidence rates compared to non-transgender men and women 9. Furthermore, transgender women have represented less than 1% of study participants in PrEP trials 10 and this paucity of data may help explain the overall low uptake of PrEP by transgender women […]
People ineligible for Medicare including newly-arrived Asian-born men who have sex with men
Reports during 2013-2017 from a large, sentinel sexual health service in Victoria showed that the proportion of newly-arrived Asian-born MSM with incident HIV infection did not decline whereas the proportion of all other MSM attending the clinic with incident HIV infection declined by 45% 6. At the same clinic during 2017, newly-arrived Asian-born versus all […]
Aboriginal and Torres Strait Islander people
The rate of human immunodeficiency virus (HIV) infection is rising in Aboriginal and Torres Strait Islanders (hereafter referred to as Indigenous) Australians. Between 2013-2017, the age standardised rate of HIV notifications increased by 41% in Indigenous populations, compared to a 12% decline in Australian-born non-Indigenous people (1). Furthermore, a greater proportion of HIV notifications during […]