Summary

  • Pre-exposure prophylaxis (PrEP) is an oral medication that prevents HIV in people at risk of infection with the virus.
  • PrEP reduces the risk of getting HIV by up to 99% when taken consistently as prescribed.
  • All GPs in Australia can prescribe PrEP.
  • PrEP doesn’t protect against sexually transmissible infections (STI). Condoms are still the best protection against infections (including syphilis, gonorrhoea, and chlamydia).
  • HIV transmission can also be prevented by using condoms during anal or vaginal sex, using sterile injecting equipment, not sharing injecting equipment or achieving and maintaining “undetectable” HIV viral loads if you are HIV-positive.

What is PrEP?

PrEP (pre-exposure prophylaxis) is oral medication taken by HIV-negative people to protect themselves from contracting HIV.

When taken daily or on-demand under the advice of your doctor, PrEP is up to 99% effective at preventing HIV.

Currently approved PrEP is a combined tablet of 2 HIV antiretroviral medications that have been used to treat HIV since 2004.

PrEP is a method of safer sex for anyone who is at risk of contracting HIV and decides it is a good option for them.

Who is PrEP for?

PrEP is for HIV-negative people at risk of HIV infection. Such as:

  • Men who have sex with men without using a condom.
  • Having  a sexual partner who is HIV-positive and not on treatment or they are at high risk of getting HIV.
  • You are sexually active and inconsistently use condoms.

PrEP isn’t necessarily for everyone and is a personal choice. Your circumstances and your risk of being exposed to HIV should all play a role in deciding whether PrEP is right for you.

Speak with your doctor to see if PrEP is your best option to prevent HIV.

How do I access PrEP?

PrEP was listed on the Pharmaceutical Benefits Scheme (PBS) from 1 April 2018.TheAustralian Government subsidises the cost of the PrEP, making it more affordable for people who need it.

All GPs (doctors) in Australia can prescribe PrEP. If you have a Medicare card, it can be purchased at a subsidised cost from all retail pharmacies, with a valid prescription. (Some pharmacies may need to order the medication in, which may take a few days.)

If you do not have a Medicare card, or cannot afford the subsidised cost, PrEP can be imported through online pharmacies. More information is available from PAN (PrEP Access Now) or the Victorian PrEP Service at the Alfred Hospital (PrEPME Clinic) on 1800 889 887.

If your doctor is unfamiliar with PrEP or what’s involved in prescribing it, they can call the Victorian PrEP Service at Alfred Hospital, on 1800 889 887

How effective is PrEP?

Studies have shown that PrEP is highly effective in preventing HIV when taken consistently as prescribed. It can reduce the risk of getting HIV by up to 99%.

Does PrEP have any side effects?

Most people who take PrEP don’t experience side effects. Others may have some mild effects like nausea, loss of appetite and headaches. These usually disappear within the first month.

A small proportion of people taking PrEP may develop kidney damage, so it is very important to have kidney tests every 6 months when you are taking PrEP.
If you have any concerns about side effects, see your doctor.

Important things to know about PrEP

Before starting PrEP, your doctor will check your health and organise some tests at your first appointment including:

  • an HIV test
  • a full STI test
  • kidney and liver function tests.

You will also receive information about how to reduce your risk of acquiring HIV.

PrEP must be taken as prescribed for maximum effective protection.

Visit your doctor every 3 months

It is recommended to see your doctor every 3 months for repeat HIV and STI tests and for a new PrEP prescription.

PrEP can have some side effects, so work with your doctor to monitor your general health.

PrEP does not provide protection against other STIs

PrEP does not protect against other sexually transmissible infections (STIs) such as:

Condoms and lubricant can provide protection against and reduce the risk of spreading a STI.

It is important to have a sexual health test every 3 months while on PrEP, even if you have no symptoms.

To find out about more about PrEP, how to access it and the costs, visit PrEP Access Now.

How long do I need to be on PrEP?

Talk with your doctor about your personal circumstances. There are several reasons that people stop taking PrEP:

  • If your risk of getting HIV infections becomes low because of changes that occur in your life.
  • You don't want to take medication every day or often forget to take your medication –other ways of protecting yourself from HIV infection may work better for you.
  • You have side effects from the medication that are interfering with your life.
  • Blood tests show your body is reacting to PrEP medication in unsafe ways. Your doctor may decide there are other options for you.

Talk with your doctor if you are having trouble remembering to take your medication or if you want to stop PrEP.

It is important to make sure that you continue taking PrEP for 28 days after your last potential exposure to HIV before ceasing it.

Are there any other HIV prevention options?

There are many easy and effective ways to prevent HIV. Other than PrEP, HIV transmission can also be prevented by: 

  • Using condoms (including female or internal condoms) with water or silicone-based lubricant during anal or vaginal sex.
  • Although there is a low risk of HIV transmission during oral sex, using male condoms on penises or dental dams on vulvas and anuses. This can also help to reduce the risk of other STIs from being passed on.
  • Using clean, sterile injecting equipment.
  • Achieving  and maintaining “undetectable” HIV viral loads (U=U) if you are HIV-positive by taking HIV antiretroviral treatment (ART) as prescribed.
  • Getting regular sexual health checks.
  • Taking post-exposure prophylaxis (PEP) – if you have potentially been exposed to HIV.

Depending on your risk factors and life circumstances, you may be more suited to other HIV prevention methods. It is important to find the right prevention method, or combination of methods, that works for you and your sexual partners.

Speak to your GP or sexual health clinician for more information.

Thorne Harbour Health (formerly the Victorian AIDS Council) has more information on PrEP. 

Where to get help

References

More information

Sexually transmissible infections

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This page has been produced in consultation with and approved by: HIV Medicine, Alfred Health

Last updated: November 2020

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