Updated advice is available on how to prescribe HIV pre-exposure prophylaxis (PrEP) and to whom.
The guidelines — developed by the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine — include detailed advice on assessment of risk factors among individuals in the broad groups likely to be eligible for PrEP, and how best to prescribe and monitor patients.
- People for whom PrEP should be considered include men who have sex with men; transgender men and women; heterosexual people at risk, such as those with an HIV-positive partner; and people who inject drugs.
- Australian specialists recommend daily PrEP for at-risk individuals rather than intermittent or coitally timed PrEP.
- Clinicians should assess patients for HIV and hepatitis B and C at baseline, and assess them for STIs, renal function and bone health.
- Rapid point-of-care HIV tests should not be used alone in assessment for PrEP.
- Initial prescription should be for a 90-day supply.
- The TGA-registered co-formulated drugs for PrEP prescription are Truvada, Trucitavir and Tenofovir EMT Lupin.
- As none are currently PBS-listed, other drugs can be imported legally under the TGA Personal Importation Scheme.
- Patients can access TGA-registered drugs under state government trials: Epic Trial in NSW, QPrEP Study in Queensland, PrEPX-SA in SA, PrEPX in Victoria and soon one in WA.
Journal of Virus Eradication 2017; online.