Australia will never be HIV-free if access to prevention requires a medicare card

The Conversation, January 23, 2019 12.21pm AEDT

by Nicholas Medland, Sexual health physician and senior researcher, UNSW

Australia aims to “virtually eliminate” HIV transmission by 2022, according to the health minister’s new national HIV strategy. This ambitious goal has been made possible by biomedical HIV prevention, a new and highly effective way of preventing HIV using medications.

But new inequalities are emerging between those who can and can’t access these medications because of their Medicare eligibility. These inequalities may undermine the success of HIV elimination in Australia and threaten Australia’s international reputation as a safe place to study, work and live.

Read more of Australia will never be HIV-free if access to prevention requires a medicare card

 

Transgender women taking PrEP have lower levels of PrEP drugs than cisgender men

aidsmap/nam, November 9th 2018

A study presented at October’s HIV Research for Prevention conference (HIVR4P) in Madrid shows that transgender women who are taking feminising hormones and also taking pre-exposure prophylaxis (PrEP) have levels of the PrEP drugs tenofovir and emtricitabine in their blood that are about 25% lower than those in cisgender men, and levels in rectal tissue cells about 40% lower. Tenofovir levels in rectal tissue were 44% lower.

However, the study also confirmed that the interaction between hormones and PrEP did not appear to go the other way; blood levels of estradiol, the one hormone all of the transgender women took in one form or another, do not appear to be affected by PrEP.

 

Post Exposure Prophylaxis (PEP) for HIV: An overview for Health Professionals

SHINE SA, October 2018

Access to PEP after an eligible exposure to HIV is a medical emergency. Your response to patients presenting for PEP can support them in preventing a life-long infection with HIV.

A brief, online training module has been created to support health professionals to:

• Increase your understanding of PEP as an emergency presentation and vital HIV prevention measure
• Assist you in providing patients with optimal care and support when seeking PEP in the emergency setting

This course is designed for Medical Officers and Registered Nurses in hospital emergency departments and targeted primary care clinical and rural sites that hold PEP starter packs in South Australia.

  • To register for the free PEP training module, please email us here with your name, position and workplace.

SA Health has contributed funds towards this program.

Newly available: WHO HIV PrEP Implementation Tool Mobile App

World Health Organization, August 1, 2018

The WHO PrEP Implementation Tool App for Health Workers App is now available.

On-the-go access to the following modules from the WHO PrEP Implementation Tool:

  • Clinical: for clinicians, including physicians, nurses and clinical officers
  • Counsellors: for staff who counsel people as they consider or start taking PrEP, and support them in coping with side effects and adherence strategies
  • Pharmacists: for pharmacists and people working in pharmacies; to provide information on the medicines used in PrEP as well as storage conditions
  • Testing providers: for people who provide testing services at PrEP sites and laboratories
  • PrEP users: for people taking PrEP and people interested in taking PrEP to reduce their risk of acquiring HIV; to support them in their choice and use of PrEP.

For more information and to download app, click here 

You can also visit these two websites:

Surgeon Who Was Denied Disability Insurance for Taking PrEP Tells His Story

Earlier this year, urology resident Dr. Philip Cheng appeared on the front page of the New York Times. Here was the headline: He Took a Drug to Prevent AIDS. Then He Couldn’t Get Disability Insurance.

The piece understandably drew widespread attention, with sharp disapproval of the denial from ID specialists and public health officials. We couldn’t understand why someone adopting the recommended strategy for HIV prevention was being penalized.

In this Open Forum Infectious Diseases podcast, he tells us some more about himself and the events surrounding his decision.

Changing attitudes to and engagement with biomedical HIV prevention by gay and bisexual men

Centre for Social Research in Health, UNSW, 2017

The latest findings from the PrEPARE Project have now been published. The  PrEPARE Project is a longitudinal study of Australian gay and bisexual men’s attitudes to biomedical HIV prevention, particularly PrEP and treatment as prevention (TasP).

With the unprecedented scaling up of PrEP access in many states over the last few years, we have observed a surge in PrEP use, and increasing levels of support for PrEP in the community. Belief in the effectiveness of TasP has also increased, although many men remain skeptical about it. The report includes national summary data. it is hoped that the report will be useful in assessing community readiness for biomedical prevention and potential issues in implementation.

Key findings:

» Nearly a quarter of gay and bisexual men (24%) reported they had ever used PrEP. This was a large increase from the 2015 survey (3%).

» Most current PrEP users were accessing it from a research study or demonstration project (82%) and the majority (74%) reported increased sexual confidence and reduced concern about acquiring HIV as a result of PrEP.

» Nearly all participants (95%) had heard of PrEP and two-thirds of participants (66%) knew someone who had taken PrEP; substantial increases from the 2015 survey. Knowledge of PrEP also improved between 2015 and 2017.

» Willingness to use PrEP has increased among HIV-negative and untested men (to 37% in 2017) and concern about using it has fallen (to 36%).

» Support for gay and bisexual men using PrEP increased to 75% in 2017, as did willingness to have sex with someone using PrEP (47%).

» Belief that HIV treatment prevents transmission increased to 20% in 2017; the increase was primarily among HIV-negative and untested men.

» Agreement that early HIV treatment is necessary increased to 79% in 2017; this increase was concentrated among HIV-positive men