PrEP Information From Pozhet

Published Date : 8 June, 2016

PrEP stands for Pre Exposure Prophylaxis. PrEP is an antiretroviral medication that is taken by HIV negative people to prevent HIV infection.  Studies from around the world have shown that if taken daily, PrEP works.

PrEP is a very effective HIV prevention tool.  It is an exciting medical advancement for anyone who might be at high risk of acquiring HIV. Among heterosexuals, PrEP might be a suitable prevention tool for partners of HIV positive people. While studies have proven that HIV treatments prevent a HIV positive person from transmitting the virus to their partners, we recognise that PrEP may play a role in decreasing anxiety around sex and intimacy for people in serodiscordant relationships.

Like any medication, the decision to start taking PrEP should be an informed decision that is made in consultation with a clinician. See the information below to learn more about PrEP and to find out more about how to access to PrEP in NSW.

PrEP faq’s

1.What does PrEP stand for?
PrEP stands for Pre Exposure Prophylaxis.

2.What is PrEP?
PrEP is a new HIV prevention method in which people who do not have HIV take a pill daily to reduce their risk of acquiring HIV.

3.How well does PrEP work?
Research in other countries has shown that people who take PrEP have a reduced chance of acquiring HIV.  How well PrEP works depends on how good people are at taking PrEP every day.  There have been six studies in heterosexual men and women which showed a significant reduction in their risk of contracting HIV when people took PrEP every day.

The TDF2 Study  found that among heterosexually active men and women who did not have HIV, PrEP reduced the risk of HIV transmission by 62%. Note that the risk reduction of 62% is a population level estimate. What this means is that a whole group of people who took PrEP were 62% less likely to acquire HIV by comparison to another group of people who did not take PrEP.  In the group of people who were prescribed PrEP not everyone took their PrEP as directed. In the group of people who were prescribed PrEP and took it every day they were far less likely to become HIV positive.

The Partner Study involved men and women in heterosexual relationships in which one partner was positive and the other negative.  The HIV negative people in these couples were prescribed PrEP and they were 75% less likely to get HIV by comparison to the HIV negative people who were prescribed a placebo.  Note that among the HIV negative people who actually took their PrEP frequently, they were protected from HIV by 90%.

4.How does PrEP work to protect against HIV transmission?
For PrEP, we know that if the drug is present in the bloodstream and vaginal and/or rectal tissues when someone is exposed to HIV, then the virus will not be able to establish itself and transmit to that individual. PrEP stops HIV from replicating so the virus is not able to establish itself in the body.

5.Who should take PrEP?
The effectiveness of using HIV antiretroviral drugs as PrEP has been established by clinical trials conducted in heterosexual adults, gay men and injecting drug users. PrEP can be considered for people in these populations who are HIV negative but at high risk of acquiring HIV.  Among heterosexual people in Australia, PrEP might be a suitable prevention tool for a HIV negative person who is in a relationship with someone who is HIV positive. Or for a woman who is trying to conceive and is in a relationship with a HIV positive man.

6.If I am trying to conceive and my partner is HIV positive, should I take PrEP?
PrEP has been used safely and with success in couples wanting to conceive. For women trying to become pregnant while using PrEP it is recommended that you start taking daily doses of PrEP once month before a conception attempt and continue until one month after the last attempt to conceive. It is strongly recommended that you speak with your clinician or a HIV paediatric service if you want to conceive and take PrEP.

7.If my partner is HIV positive but they are on treatment and they have an undetectable viral load, should I still take PrEP?
There is strong evidence to suggest that a person who is HIV positive but with an undetectable viral load is very unlikely to pass on HIV. In 2011 the HPTN052 study found that starting HIV treatment early reduced the risk of a HIV positive person transmitting the virus to their HIV negative partner by 96%.  This finding in relation to heterosexual couples was later mirrored by studies which examined homosexual couples.

Because treatment is so effective at preventing onward transmission of HIV, someone who is in a relationship with a HIV positive person on effective treatment, is not considered to be at high risk of acquiring HIV and therefore it would not always be recommended that they start taking PrEP. However some people who have partners with an undetectable viral load often still consider other ways of protecting themselves against HIV.  For neg/pos couples PrEP may be a prevention tool that reduces anxiety and enables a greater sense of security and intimacy within a relationship.

8.Do I have to test for HIV before I start taking PrEP?
It is essential that you have an HIV test before beginning PrEP and if you decide to take it, you need to continue to test for HIV and other sexually transmissible infections on an ongoing basis – at least every three months. Your doctor can also give you advice about any other monitoring that may be required.

9.If I start taking PrEP do I need to worry about side effects?
Truvada and the generic PrEP medicine which contain the same ingredients (TDF/FTC) are generally very well tolerated and most of the potential side effects are quite mild. A minority of people may experience mild symptoms such as nausea, headaches and fatigue. If this occurs, symptoms mostly disappear after the first few weeks on PrEP. In a minority of cases, some have experienced more severe side effects.  If at any stage you are concerned that you may be experiencing side effects from taking PrEP, you should contact your clinician.

Long term PrEP can place added stress on your kidneys and liver, for this reason these organs need to be monitored while taking PrEP. If you have existing kidney, liver or bone problems such as osteoporosis, or are taking any other medications, speak to your clinician about whether taking PrEP is the right choice for you.

10.If I am taking PrEP, how often do I have to take it?
It is recommended that you take PrEP once a day, every day. Every PrEP study to date has shown that people who took PrEP once a day every day, experienced greater protection against HIV in comparison to those who did not take their PrEP every day.

11.What if I miss a dose or occasionally forget to take PrEP?
If you miss a dose of PrEP, don’t panic. Resume taking your pills as soon as you remember. It is not recommended to double dose on PrEP to make up for missed doses. If you consistently miss doses, you may lose some of the protective benefits of taking PrEP.  If you miss two days of PrEP in a row it will take seven days of taking PrEP daily before you are again protected at a substantial level.

12.If I am on PrEP should I keep using condoms?
When PrEP is taken daily it is highly effective in preventing HIV transmission and gives protection against HIV transmission that is comparable to condoms, although it is not a guarantee against infection. Using condoms will be a choice for you and your sexual partners or partner. However, it is important to remember that PrEP does not prevent the transmission of other STIs. If you do not use condoms, it is important to test regularly and treat STIs if you acquire them.

13.Does PrEP start working immediately?
It takes time for PrEP to build up to levels in your body that are considered protective. The exact length of time is still not clear and is being investigated.Data from studies have shown that protection is achieved after 7 days for rectal tissue, however for full protection to be achieved in blood and vaginal tissue it will take 20 days.
To be on the safe side you should assume that you aren’t getting maximum protection until at least 20 days after you begin taking PrEP, if you take it consistently without missing any pills. This is recommended for all people taking PrEP.

How to Access PrEP

EPIC-NSW

EPIC-NSW is a study run by the Kirby Institute, in collaboration with a number of partners, which aims to assess the impact of the rapid expansion in access to PrEP amongst those at high risk of acquiring HIV. The trial will enrol 3 700 people, these people will receive PrEP free of charge for a 24 month period.

Please note that partners of HIV positive people who are on treatment and have an undetectable viral load, are not considered high risk for HIV and therefore would not be deemed eligible for the EPIC-NSW study.

For more information on the EPIC-NSW study, visit the Ending HIV website here. endinghiv.org.au/

Other PrEP Access Options

For those who would like to access PrEP but are not eligible for the EPIC-NSW study there are other options.

For more information, please download this resource which explains your options for obtaining PrEP through the Australian health system, and how to go about obtaining generic Truvada via the internet if you and your doctor decide that is your best access option: (PrEP – Access Options). endinghiv.org.au/nsw/stay-safe/prep/

More Information on PrEP

The Australasian Society of HIV Medicine has posted the Australian National PrEP Guidelines on the (ASHM ARVG website.) arv.ashm.org.au/arv-guidelines/prep-resources-for-clinicians

For more information on importing medicines for personal see the (Australian Government’s Therapeutic Goods Administration TGA) website.) tga.gov.au/importing-mail-or-courier

Living Positive Victoria has produced a resource to assist people with HIV to talk to their friends and partners about PrEP which is on  (their website.) livingpositivevictoria.org.au

In NSW you can now contact the PrEP Info Service, which provides further information for community members and health care professionals about Pre-Exposure Prophylaxis. Call the service on 1800 451 624, open Monday to Friday 9am till 5:30pm.

Pozhet
Heterosexual HIV info line 1800 812 404
pozhet@pozhet.org.au

ACON
9206 2000
acon@acon.org.au

Positive Life NSW
9206 2177
1800 245 677 (freecall)

This information has been produced by Pozhet in partnership with ACON

Privacy

Published Date : 22 August, 2012

The Pozhet Service is part of the Sydney Local Health District (SLHD) which is part of the NSW Government. All of the individuals working in SLHD are bound professionally and ethically to keep your information confidential. We respect an individual’s right to privacy as established under the Privacy and Personal Information Protection Act 1998 (NSW) and the Health Records and Information Privacy Act 2002.

We will not discuss your personal information with anyone without your permission, unless we are required to do so by law.

We do not allow the publication of information that identifies or may identify an individual (unless they have consented).

This site also contains links to external sites. Pozhet and SLHD do not have any responsibility for the privacy practices of third party sites.

Is personal information collected about your website visit?

Visitor logs are collected on this website for statistical purposes only (nothing is identifiable).

What does SLHD do with personal information provided via this website?

Visitors are welcome to provide feedback about SLHD when they visit the website. Email addresses or other details provided to this site will only be used to respond to enquiries and will not be added to mailing lists, or disclosed to any other party without the user’s consent, unless required by law.

Personal information will be kept safe, sufficient to prevent unauthorised access, and will be properly handled to ensure its safety, integrity and confidentiality.

Want to know more?

Read the full NSW Government Privacy Statement.

Questions and Answers

Published Date : 26 July, 2015

Send us your stories

Published Date : 22 October, 2012

Have you ever had a moment when you heard someone’s story about living with HIV and it brought tears to your eyes? Did you learn something? Did you feel you could relate to what they said, or did it make you realise something marvellous about yourself? Did you feel connected, that someone understands, or that you are a great and strong person?

That’s the power of a personal story. It touches people’s lives and makes you feel you’re not alone. Stories heal, they teach and they touch hearts. And we all have a story to tell. No matter how boring you think your story is, it will be interesting to someone.

We’d like to hear how you live your life with HIV. Be anonymous, make up a new name and change the town or the people. But don’t forget that you matter and you can make a difference.

We would love to share your story on this website. You can write as much or little as you like; it may be a paragraph but you may find you have a book in you!

If you don’t like writing, Pozhet staff can meet with you to help. We can even organise a professional audio recording (‘podcast’).

Send us your story or point of view.

All stories will be kept in absolute confidence. We will only ever use your story with your permission and we will conceal identities.

Sitemap

Published Date : 14 January, 2015

Test your HIV knowledge

Published Date : 15 March, 2014

[WpProQuiz 1]
The quiz consists of basic information for the newly diagnosed HIV positive person and anyone who wants to learn more about HIV.

•  transmission, or how HIV is passed from person to person
• pregnancy
• HIV treatments
• myths around HIV and AIDS
• new information about staying healthy after being diagnosed with HIV

Test your STI knowledge

Published Date : 16 September, 2015

[WpProQuiz 2]

Test your STI knowledge

Testing Options

Published Date : 5 April, 2018

HIV testing is free, easy, fast and confidential

It usually involves a simple blood test. To make you feel comfortable there are many places you can go to get a HIV test:
• GPs
• Family Planning Clinics (FPNSW)
• Aboriginal Medical Services
• Sexual health clinics
• Community-based rapid HIV testing sites (for men who have sex with men)
A consultation fee will be charged at non-bulk billing GPs. If you do not have a medicare card you can get tested at FPNSW or at Sexual Health Clinics.

You can also have a Dried Blood Spot (DBS) HIV test sent to your home especially if you are nervous about visiting a service.
The DBS HIV Test is a new testing option available in NSW to some people at risk of HIV. This includes men who have had sex with men; people from countries where HIV is more common (Africa or Asia); or people who have sexual partners from these regions. For more information and to see if you are eligible go to hivtest.health.nsw.gov.au
For confidential information on where to get a HIV test call the NSW Sexual Health Infolink on 1800 451 624.

Who can get HIV?

Many people are surprised that heterosexual people can get HIV. There are about 10,000 people in NSW living with HIV, and one in five people get it through heterosexual sex. In Australia, most HIV infections are in men who have sex with men, but HIV can also be passed on during sex without condoms between men and women. People can also get HIV through sharing needles when injecting drugs, but this is less common in Australia. You can get HIV at any age and in any country. Many people diagnosed with HIV are Australian born and over 55. A growing number of Australian heterosexuals get HIV when travelling overseas, particularly in countries where rates of HIV are high. The best way to be sure is to take condoms with you when you travel and make sure you have an HIV test on your return.

If you are sexually active, and do not use condoms ask your doctor about a HIV test and general sexually transmitted infection (STI) check up.
If you have any of these risk factors you can get a test – [link to ending hiv page?]

When I have an HIV test how long do I have to wait to get an accurate result?
Most laboratories in Australia use the combined antigen and antibody test which is able to indicate HIV between 2 – 6 weeks after exposure. I
The Dried Blood Spot (DBS) test can be done in the privacy of your home. If your test is reactive (positive) you will be notified and you will need to do a confirmation test. For more information you can go to the DBS website. [https://www.hivtest.health.nsw.gov.au/]
Link to DBS website

So why is HIV testing so important?

Many people don’t know they have HIV, which means they are not getting the health benefits of being on HIV treatment and may pass HIV onto others. Nearly 50% of heterosexuals are diagnosed late, which means many years after HIV has started having an effect on their immune system. Knowing you have HIV means you can start treatment straight away and stop HIV damaging your immune system. Effective treatment now means you are not infectious during sex, so being diagnosed and treated means you can manage your health and eliminate any risk of transmission to others.

Treatment - Prevention - the latest studies

Published Date : 5 June, 2013

HIV treatment significantly reduces transmission – the science is in!

The Swiss Statement – In 2008 the Swiss Federal Commission for HIV released a controversial statement saying that individuals with an undetectable viral load and no STI (sexually transmitted infection) cannot transmit HIV during sex.

Four of Switzerland’s top HIV experts had reached a consensus, resulting in a public statement that sent the global HIV sector into a spin. Their assertion that people with HIV on effective treatment (ART or AntiRetroviral Therapy) posed a negligible risk to their sexual partners was based on ‘review of the medical literature and extensive discussion’ and was, they asserted, ‘much more informed’ than in 1986 when the statement ‘HIV cannot be transmitted by kissing’ was publicised.

Still, the outcry was immediate. While some HIV organisations cautiously welcomed the statement, others expressed concern that it only pertained to heterosexual couples, (as if heterosexuals never engage in anal or group sex), and that it would prompt people with HIV to forget about condoms, risking STIs and possibly transmitting HIV if they didn’t monitor their treatment adherence.

It was also argued that, in between viral load tests, who knew whether the virus was really undetectable. More than one organisation called for caution, while others released their statements, warnings and rebuttals.

HPTN052 Study – Then in 2011 a large randomised clinical trial over 5 years produced more solid evidence…HIV treatment significantly reduced infectiousness. In fact, in the group which received early treatment, only one transmission occurred – and that was before the HIV positive person’s viral load had gone undetectable. The study concluded ART is 96% effective in reducing transmission. It could be argued that figure would be higher if you add the criteria of the Swiss Statement – undetectable for 6 months, no STI present and regular viral load monitoring. The one transmission that occurred in the group taking ART was from a person who had not been on treatment long enough to achieve an undetectable viral load. HPTN052 proved the Swiss Statement was correct. Something many already believed. After all, would the top HIV medical experts in Switzerland release a statement like that if they weren’t really and truly convinced? And now we have what is already being called the UK Statement.

In January 2013 the British HIV Association (BHIVA) and the Expert Advisory Group on AIDS (EAGA) released a position statement on the use of ART to reduce HIV transmission. It states that, in serodiscordant couples (where one has HIV and the other does not) where the partner who is HIV positive is taking effective ART, the risk of transmission through vaginal intercourse, is ‘extremely low’ provided the following conditions are fulfilled: There are no sexually transmitted infections in either partner The person with HIV has had a sustained plasma viral load below 50 copies/ml for more than six months, including the most recent test. Viral load testing occurs every three to four months (i.e. more regularly than in standard clinical care). It goes on to say that successful ART used by the HIV positive partner is as effective as consistent condom use in limiting HIV transmission. The UK statement also says that in its expert opinion, the risk of transmission during unprotected anal intercourse is extremely low, provided the above conditions are met, although they acknowledge that receptive anal intercourse carries a higher risk in general.

So, all in all it looks good for serodiscordant couples! If you are HIV positive and considering having a relationship or being sexual again, get informed and stay in touch with your HIV doctor. Once you understand what to do to minimise risk, you can have sex without worrying…and that’s got to be good news!

Feel free to research the studies yourself, and let us know what you think…will it help you in your relationships?

Does it give you and your partner peace of mind?

How good are you at taking your meds?

Leave your comments below…

Website Terms of Use

Published Date : 24 October, 2012

Pozhet encourages people to use this website to talk about things which are important to them and to share their experiences and knowledge.  These guidelines exist to make sure this website is  safe and comfortable for everyone to use.

Some Guidelines:

Do:

1. Make comments – we want to hear your opinion and experiences. Even a small comment or words of support can make a difference to people.
2. Keep coming back to the site to see if anyone responds to your comment and keep the conversation going.
3. Respect the views of others. It is OK to disagree – we want debate and to hear a variety of opinions, but we want it to be positive.
4. Use care to protect your privacy, and the privacy of others.
5. Report any conduct on the website that concerns you.

Don’t:

1. Be a “troll”. Trolls intentionally incite or annoy. If you do this we may delete your comments.
2. Bully, threaten, harass or intimidate anyone. You can get your point across more effectively if you are polite.
3. Use “CAPS LOCK” (all capital letters). This can be seen as shouting and maybe offensive.
4. Post personal information about anyone.
5. Impersonate anyone. You can use an anonymous name or a character but you cannot intentionally use someone else’s identity.

Comments will not be published if they:

1. Identify or reveal personal information about anyone.
2. Defame, harass, bully, or intimidate anyone or any organisation.
3. Are intolerant of race, gender, culture, appearance, sexual preference, religion, health (including HIV) or age.
4. Are obscene or use inappropriate language (swear words).
5. Are advertising or promote a commercial product.
6. Are otherwise offensive, irrelevant, inappropriate or illegal.

How Pozhet moderates this site

Comments are scanned automatically for offensive language and spam, then manually checked by Pozhet staff to determine if the comment should be published, edited or deleted. We do require your email address to be provided when writing a comment. This is for security reasons. We will not publish your email address on the website, we will only publish the name you want used.

Pozhet will notify individuals if and why comments breach these guidelines, and reserve the right to block and/or report individuals who repeatedly ignore the Terms of Use. If you have a complaint or feedback we encourage you to let us know and we will deal with it as quickly as we can.