References
Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2018. Sydney: Kirby Institute, UNSW Sydney; 2018. Available at: https://kirby.unsw.edu.au/report/hiv-viral-hepatitis-and-sexually-transmissible-infections-australia-annual-surveillance (last accessed 27 August 2019). Grulich AE, Guy R, Amin J, et al; Expanded PrEP Implementation in Communities New South Wales (EPIC-NSW) research group. Population-level effectiveness of rapid, targeted, high-coverage roll-out […]
Suitability for PrEP
Pre-exposure prophylaxis (PrEP) medications are registered in Australia with the Therapeutic Goods Administration (TGA) and they are subsidised by the Australian Pharmaceutical Benefits Scheme (PBS). All general practitioners, other medical specialists, and authorised nurse practitioners can prescribe PrEP using a PBS streamlined authority arrangement. No specialist training is required to prescribe PrEP, however resources and […]
PrEP suitability criteria for men who have sex with men
Box 4.1 PrEP suitability criteria for men who have sex with men HIV risk in the previous 3 months and the future 3 months The clinician should prescribe PrEP if the patient describes a history of any of the following HIV acquisition risks in the previous 3 months and if the patient foresees that there […]
PrEP suitability criteria for trans and gender diverse people
Only a small proportion of participants in PrEP studies have been transgender (trans) or gender diverse people 2, 3, 4. As a result, limited data are available for these populations. Incorrect assumptions can be made about trans people and their sexual practices, as they may practice vaginal/neovaginal and anal intercourse, both insertive and receptive. Trans and gender-diverse people […]
PrEP suitability criteria for heterosexuals
Box 4.3 PrEP suitability criteria for heterosexuals HIV risk in the previous 3 months and the future 3 months The clinician should prescribe PrEP if the patient describes a history of any of the followingHIV acquisition risks in the previous 3 months and if the patient foresees thatthere are likely to be similar acquisition risks […]
PrEP suitability criteria for people who inject drugs
In the first instance, people who inject drugs (PWID) should be advised of and provided with options for using sterile needles, syringes and other injecting equipment, and offered opioid substitution therapy for those who use opioids. People who inject drugs can be referred to local needle and syringe programs, or the Australian Injecting and Illicit Drug Users League […]
Suitability for PrEP – Parallel chapter
References
Australasian Sexual Health Alliance (ASHA). Australian STI management guidelines for use in primary care[internet]. Taking a sexual history and contact tracing. Updated December 2018. Available at: http://www.sti.guidelines.org.au/resources/how-to-take-a-sexual-history#how-to-take-a-sexual-history (lastaccessed 3 September 2019). Grant RM, Sevelius JM, Guanira JV, Aguilar JV, Chariyalertsak S, Deutsch MB. Transgender women inclinicaltrials of pre-exposure prophylaxis. J Acquir Immune Defic Syndr 2016;72 Suppl 3:S226-9. […]
HIV testing
All patients whose sexual or drug injection history indicates the recommendation or consideration of pre-exposure prophylaxis (PrEP), and who are interested in taking PrEP, must undergo laboratory testing. The tests identify those for whom this intervention would be harmful, or in whom it could present specific health risks that would require close monitoring. HIV testing […]
Concerns about TD* or FTC resistance
Overall, the risk of developing TD* or FTC resistance among participants on PrEP is low 9. According to a World Health Organization (WHO) meta-analysis of HIV resistance data from randomised clinical trials of PrEP, participants on PrEP versus placebo who started PrEP at the time of acute HIV infection had a higher risk of developing resistance, with more […]