Information about TRUVADA and ATRIPLA delisting

Australian Federation of AIDS Organisations (AFAO), March 30th 2020

From 1 April 2020 Truvada for HIV treatment and for pre-exposure prophylaxis (PrEP) will no longer be available through the Pharmaceutical Benefits Scheme (PBS).

There are alternatives to Truvada for PrEP in Australia.

Community members eligible for PrEP can access generic versions of Truvada supplied by Apotex, Mylan and Lupin Generic Health. The drugs manufactured by these three suppliers contain the same active ingredients as Truvada.

In addition, from October 2020 Atripla will be delisted. A generic equivalent of Atripla has been approved by the PBS for community members who wish to continue using Atripla.

We encourage you to talk to your prescribing doctor if you want more information about these changes.

For more information, visit the following websites:

Emergency contraception awareness in an at‐risk population

Hope, D. L., Hattingh, L. and King, M. A. (2019) J Pharm Pract Res. doi:10.1002/jppr.1554

Background

Consumer awareness of emergency contraception is generally poor. School leavers (schoolies) engage in risky behaviours, including casual sex and alcohol and drug consumption.

Aim

The aim of this study was to explore the awareness of an at‐risk population of schoolies regarding the use and availability of emergency contraception.

Methods

An electronic survey was self‐administered by participants using Wi‐Fi‐connected iPads at the Schoolies Wristband Distribution Centre, Surfers Paradise, on the first day of Queensland Schoolies Week, November 2017. Outcomes measured were awareness of the availability of emergency contraception from a pharmacy, maximum time for effective use following unprotected intercourse and whether emergency contraception is harmful to the health of the user.

Results

Schoolies completed 498 valid surveys. Most (83.5%) were aged 17 years and 50.8% were aware that emergency contraception is available from community pharmacies with prescription and 36.7% were aware that it is available without prescription; 18.5% were aware of the 72‐ or 120‐h effectiveness window and 38.0% agreed that it is not harmful. All questions were associated with considerable uncertainty. Females were 1.8‐ to 3.2‐fold more likely than males to provide an appropriate response to any emergency contraception statement.

Conclusion

Schoolies’ awareness of emergency contraception availability, effectiveness window and safety was low. At‐risk schoolies may not access emergency contraception when indicated due to fear of harm, uncertainty about its effectiveness window or a lack of knowledge about timely non‐prescription access from community pharmacies. Targeted education may improve current knowledge gaps. The misnomer ‘morning‐after pill’ should be abandoned for the clinically appropriate term ‘emergency contraception.

 

International consensus on testosterone treatment for women

Jean Hailes, 2 September 2019

The first Global Position Statement on the use of testosterone in the treatment of women, led by the International Menopause Society (IMS), was published in four leading international medical journals today.

The statement has been authored by a diverse team of leading experts based around the world and has been endorsed by internationally-esteemed medical societies.

It follows years of debate regarding testosterone therapy for women and, for the first time, provides agreement among experts and medical societies about how testosterone could be prescribed for women.

Access the statement: 

It’s time to lift the restrictions on medical abortion in Australia – Professor Caroline de Costa

The Conversation, April 1, 2019 6.13am AEDT

Over the past thirteen years, many Australian women have used the drug mifepristone (RU486) to bring about a medical abortion.

Rather than undergoing a surgical abortion in a clinic or hospital operating theatre, a medical abortion is induced by taking drugs prescribed by a doctor.

But while mifepristone has been available in Australia since 2006, only some women, in some parts of the country, are able to access it. Professor Caroline de Costa argues in the Medical Journal of Australia that this needs to change.

Smoking and HIV: what are the risks and what harm reduction strategies do we have at our disposal?

AIDS Res Ther. 2018 Dec 12;15(1):26. doi: 10.1186/s12981-018-0213-z.

Abstract

The World Health Organization estimates that smoking poses one of the greatest global health risks in the general population. Rates of current smoking among people living with HIV (PLHIV) are 2-3 times that of the general population, which contributes to the higher incidence of non-AIDS-related morbidity and mortality in PLHIV.

Given the benefit of smoking cessation, strategies to assist individuals who smoke to quit should be a primary focus in modern HIV care.

Tobacco harm reduction focuses on reducing health risk without necessarily requiring abstinence. However, there remains uncertainty about the safety, policy and familiarity of specific approaches, particularly the use of vaporised nicotine products. Evidence suggests that vaporised nicotine products may help smokers stop smoking and are not associated with any serious side-effects. However, there is the need for further safety and efficacy data surrounding interventions to assist quitting in the general population, as well as in PLHIV specifically.

In addition, official support for vaping as a harm reduction strategy varies by jurisdiction and this determines whether medical practitioners can prescribe vaporised products and whether patients can access vaporised nicotine products. When caring for PLHIV who smoke, healthcare workers should follow general guidelines to assist with smoking cessation.

These include: asking the patient about their smoking status; assessing the patient’s readiness to quit and their nicotine dependence; advising the patient to stop smoking; assisting the patient in their attempt to stop smoking through referral, counselling, pharmacotherapy, self-help resources and/or health education; and arranging follow-up with the patient to evaluate their progress.

Clinical Education Forum Recording: Contraception Update

SHINE SA, November 2018

Clinicians:  SHINE SA is pleased to present the following Clinical Forum by Dr Amy Moten on the topic of Contraception.

This recording is available free of charge, and access is limited to three months only.

This forum covers emergency contraception and new formulations of the Pill.

3 Category 2 RACGP Points can be awarded on completion of the forum.

Recording length: 1 hour 18 minutes