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An important development in HIV/AIDS policy and practice in Australia – and globally – is the increasing accessibility of HIV pre-exposure prophylaxis (PrEP). However, research about PrEP indicates that inequities exist.

Wendy Manson, Director of The Kirby Institute, The University of New South Wales

There are increasing numbers of HIV-positive people in Australia and around the world who have regular access to life-saving antiretroviral (ARV) treatment. However, for those who don’t have access to ARV treatment, whether because they cannot afford treatment or other reasons, we have increasingly seen a growing number of people living with HIV also getting protection from new HIV infections through pre-exposure prophylaxis (PrEP).

PrEP is the regular daily use of drugs to prevent HIV infection. While the best known example of PrEP is the use of Tenofovir or TDF to prevent the infection in people who are HIV negative, other medicines that can protect people against HIV have been developed. These other drugs are all once-daily oral medicines that are cheap and taken at a time in the day when HIV is more likely to be transmitted.

So why is PrEP so important? This is because the infection can be prevented when someone is in the early stages of HIV infection before they develop any symptoms. An effective PrEP package also has to include a programme for other services such as partner services to support people and couples who are in a long-term relationship, because research has found that people at higher risk of HIV are more likely to have sex with partners of a different gender.

With PrEP, people can change their sexual and drug using behaviour, which may help to reduce the transmission of HIV from their sex partners. This reduces the number of people who acquire the infection and reduces the burden on HIV services.

In Australia, the first PrEP trial was

 

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