Guidance for providing a six-month supply of oral PrEP in the form of tenofovir disoproxil + emtricitabine.
In the second quarter of 2026 the Pharmaceutical Benefits Scheme (PBS) increased the number of repeats that medical and nurse practitioners can prescribe for HIV pre-exposure prophylaxis (PrEP), in the form of tenofovir disoproxil + emtricitabine.
A six-month supply (180 tablets) of tenofovir disoproxil + emtricitabine can now be prescribed and obtained from a single script. Clinicians have the option of writing a PrEP script for 1 pack (30 tablets) with five repeats OR writing a script for 2 packs (60 tablets) with two repeats.
NOTE: scripts providing 2 packs and two repeats will attract only one co-payment for 2 packs, an important advantage, particularly where cost is a barrier to adherence.
Summary table:
New to PrEP (daily or on-demand) | 3 months (90 tablets) |
|---|---|
Established on PrEP (daily or on-demand) | 6 months (180 tablets) |
Recommencing PrEP (daily or on-demand) | 6 months (180 tablets) |
NOTE: For all the above patient scenarios, where there are potential issues with adherence, medical conditions requiring more frequent monitoring (e.g. renal disease), or patient preference | 3 months (90 tablets) |
Please note that this guidance applies to all patients on PrEP irrespective of whether they have access to Medicare.
Patients who are PrEP naive and who are seeking daily PrEP
- Evaluate the patient’s suitability for PrEP
- For those patients for whom PrEP is suitable, provide a script for a 3-month supply of PrEP (90 tablets)
- Review the patient at 3 months to assess medication adherence and tolerability, and to perform laboratory and HIV/STI testing. At that time, patients with good PrEP adherence and tolerability can be offered a script that provides a six-month supply of PrEP (180 tablets)
Patients who are naive to PrEP who are seeking on-demand PrEP
- Evaluate the patient’s suitability for PrEP
- For those patients for whom PrEP is suitable, provide a script for a 3-month supply of PrEP (90 tablets)
- Note: Patients using on-demand PrEP may need 8-10 tablets to cover a week of sexual activity. For example, in one week 8 tablets may be required to cover two separate episodes of sex, or 10 tablets may be required if on-demand PrEP is commenced then daily sexual encounters continue over a seven-day period.
- Review the patient at 3 months to assess medication adherence and tolerability, and perform laboratory and HIV/STI testing. At that time, patients with good PrEP adherence and tolerability can be offered a script that provides a six-month supply of PrEP (180 tablets).
Exceptions to the advice regarding patients who are PrEP naive
- Some patients new to PrEP will need more regular clinical reviews during their first 3-months of PrEP use based upon their individual social circumstances and baseline laboratory test results, e.g. they may have reduced renal function at baseline that requires regular monitoring, or they may have difficulty with adherence
- Some patients new to PrEP may prefer to have ongoing 3-monthly PrEP assessments
- Some patients new to PrEP who are travelling overseas for prolonged periods may seek more than a 90-day supply of PrEP. In this setting, a clinician may decide to provide a script that offers more than 3 months of PrEP. In this scenario clinicians should seek assurance from the patient that they will undergo HIV and STI testing at the usual 3-month mark and provide the results to their PrEP prescriber in Australia
Patients who are currently established on daily or on-demand PrEP e.g. they have demonstrated good medication adherence and tolerability over time
- Offer these patients a script for six months of PrEP (180 tablets)
Exceptions to the advice regarding patients currently established on daily or on-demand PrEP
- Some patients will need more regular ongoing clinical reviews based upon their individual social circumstances and baseline laboratory test results, e.g. they may require regular laboratory monitoring of renal function, or may have difficulties with adherence
- Some patients who are established on PrEP may prefer to have ongoing 3-monthly PrEP assessments
Patients who have previously been on PrEP and who are seeking to recommence PrEP
- Evaluate the patient’s suitability for PrEP
- For those patients for whom PrEP is suitable the clinician may
- offer a six-month supply of PrEP (180 tablets) to those patients who had previously been stably established on PrEP and who are deemed likely to have good medication adherence and tolerability
- offer an initial three-month supply of PrEP (90 tablets) to people who had previously been stably established on PrEP, but whose current circumstances have changed e.g. change in renal function, change in social circumstances
- offer an initial three-month supply of PrEP (90 tablets) to those patients who had prior difficulties using PrEP or a history of reduced renal function
- For those patients recommencing PrEP but who are offered an initial three-month supply of PrEP (90 tablets), their suitability for a six-month PrEP supply (180 tablets) should be reviewed regularly in the future
Laboratory and HIV/STI monitoring of patients who are receiving a six-month supply of PrEP
Once a patient is provided with a six-month supply of PrEP (180 tablets), HIV and STI monitoring should continue according to the Australian STI Management Guidelines and should not be reduced because the PrEP prescribing interval is longer. Where a patient receives a six-month PrEP supply and attends clinical review only every 6 months, a pathology request form for HIV and STI testing should be provided for testing at the interim 3-month point.
Testing recommendation summary
- 3-monthly testing for HIV and STIs is recommended for all people taking PrEP including:
- HIV serology (Ag/AB test)
- Syphilis serology
- NAAT/PCR gonorrhoea/chlamydia
- Hepatitis B serology if not vaccinated/not immune
- Annual Hepatitis C Virus (HCV) antibody testing, or annual HCV PCR for those with
known positive HCV antibody is still recommended, as is
Acknowledgement of Country