In their recent 2019 draft guidelines, the ASHM panel continues to recommend that daily PrEP should be available for all populations at risk of HIV which includes heterosexuals.
The guidelines list criteria to determine PrEP suitability for heterosexuals includes:
- Condomless anal or vaginal sex with a partner who is not on treatment or is not undetectable
- Condomless anal or vaginal sex with casual HIV positive partners or a male homosexual or bisexual partner of unknown HIV status
- Planned condomless sex in an effort to conceive with a HIV positive partner regardless of viral load
- Deteriorating mental health and a history of risk behaviour including binge drinking and drug use
PrEP can also play an important role for people travelling overseas. Heterosexual men and women who want to take PrEP when overseas should commence PrEP at least 7 days before departure.
These guidelines also mention that if a HIV serodiscordant couple experience suffering and anxiety about HIV transmission despite the positive partner being undetectable then PrEP can be considered.
GPs, health workers and heterosexuals at risk need to be educated about the value of PrEP in these settings.
For more details about these guidelines which have not yet been endorsed by the Blood Borne Viruses and Sexually Transmissible Infections Standing Committee go to ashm.org.au/products/product/prepguidelines19