Pre-exposure prophylaxis, PrEP, is a drug which if taken daily can prevent HIV infection.
More than 27,000 Australians are living with HIV and PrEP is a potential game-changer, but it can be frustratingly difficult to access.
The drug only offers protection against HIV and does not prevent other harmful STIs. Sexual health experts continue to recommend condoms for those on PrEP.
Marketed under the brand name ‘Truvada’ by Gilead, PrEP is available in Australia. However, the price can be prohibitive and the government has just knocked back a request to have it subsidised under the Pharmaceutical Benefits Scheme.
But if you’re a gay Australian man who wants PrEP, or a woman at high-risk, there are affordable and even free ways to access it.
Note: PrEP is different to PEP. PEP is a post-exposure prophylaxis, which can be effective up to 72 hours after a sexual encounter. PEP is available 24/7 from hospitals and medical centres around Australia (Call 1800 737 669 for more information).
1. Get a prescription and purchase over the counter
This is an astoundingly expensive way to get PrEP, even if it's the most reliable.
Ruth McNair, a fellow of the Royal Australian College of General Practitioners and part of their sexual health special interest group, said all Australian GP's have the ability to proscribe PrEP, though some may not have heard of the drug before.
To find a GP who is well aware of PrEP we recommend googling and calling your nearest sexual health clinic, or your state or territory’s HIV/AIDS council or LGBT+ health group.
There’s also a list of PrEP prescribing doctors in Australia here.
Your doctor will be able to advise you on the effectiveness of PrEP, potential side-effects, and any interactions it may have with other medications.
If you’re living remotely, don’t be shy about asking your GP to do the research so they can give you a prescription.
The drug is relatively new to the Australian market so some GPs may not have encountered it before, especially outside of metro areas.
You’ll also need to find a pharmacy that stocks the drug. Get ready for a shock though, it will be expensive to purchase domestically.
Chemist Warehouse lists the drug at $841.69 for a one month supply - that’s $28 a day.
There are cheaper ways though…
2. Get a prescription and order it online
To get PrEP online, you’ll still need a prescription (see above).
The reason it’s so much cheaper is that only one producer has applied to sell the drug in Australia. Online you’ll have access to cheaper generic versions.
Importation is permitted under the personal importation scheme rules set by the Therapeutic Goods Administration. Only a three month supply for personal use is permitted.
While the imported generics are licenced from the original producer, they're not covered by Australian regulatory standards.
“We’re supplying prescriptions for people to self-import because it’s a harm minimisation approach,” Doctor McNair told SBS. “We can’t guarantee that it’s actually the drug that it says it is, but it’s better than nothing.”
Dr McNair is not aware of any cases where there have been issues with self-importation, “but how would we know? That’s the problem.”
Prices can be as low as $53 a month, a more manageable $1.80 a day.
PrepAccessNow also has a number of free coupons they provide to students, the unemployed, or others facing financial hardship.
The group is not comprised of doctors, nor can they provide medical advice.
3. Get yourself on a state government trial
New South Wales, Victoria and Queensland are both currently running trials of the drug to lower HIV transmission rates – essentially making it free for thousands of people.
A South Australian trial will be starting soon.
Ostensibly the trials are studying the "uptake of PrEP among eligible individuals" and to investigate whether it’s an effective way of controlling HIV – but they also have the side-effect of increasing and encouraging access to the drug.
Some clinics bulk-bill while others may have a gap, so it’s worth asking what the deal is before booking yourself an appointment.
The trials are for those at highest risk of HIV infection, which includes men who inform their doctors that they have had unprotected receptive anal sex in the last few months, and may do so in the future.
Both women and men with HIV-positive partners are also considered high risk.
More on PrEP:
You should only use PrEP with a valid prescription and after a proper consultation with your doctor – none of the information above is a substitute for proper medical advice.
For more on PrEP see the Australian Federation of AIDS Organisations, the Ending HIV fact sheet and PrEPAccessNOW. If you're a GP and want to learn more about PrEP, the Australasian Society for HIV Medicine (ASHM) provides resources to practitioners online.
You can do your part to end HIV/AIDS in Australia by knowing your status, being honest with your partners, and practicing safe sex.
Consider sharing this post, you could prevent a friend getting infected by HIV.