Increase in PEP use drains services
The HIV-related treatment PEP has been discontinued at the Albion Street Centre and was almost cut from St Vincent’s Hospital after the increasing use of the service exhausted funding.
PEP has meant that the Albion Street Centre is over budget for this year. It’s not a situation that is tenable for this Centre to continue, Albion Street Centre director Dr Julian Gold told Sydney Star Observer. The Centre has ceased providing the drugs but will continue offering counselling and referrals.
Post-exposure prophylaxis (PEP) is a course of medication taken over approximately four weeks designed to reduce the possibility of infection with HIV. The treatment is prescribed when there has been a known high-risk exposure to HIV and must be commenced within three days of the event to be effective.
The increase in use of the treatment since 2001 meant Albion Street’s $20,000 PEP budget for this year blew out to $150,000, Gold said. PEP was conceived and introduced at a time when there wasn’t a significant increase in HIV. It was thought that the uptake of PEP would be fairly low, Gold said.
Gold attributed the increase in the use of PEP to a rise in unprotected sex in the gay community, over-prescribing of the course by doctors and the increasing use of party drugs associated with unsafe sex. Gold also raised concerns that some patients had accessed PEP up to six times. That’s a real problem, it’s not healthy at all, he said.
A 20 percent increase in the use of PEP at St Vincent’s Hospital also led to a proposal by the hospital to cease providing the drugs on 21 June. However, a last-minute meeting between South Eastern Sydney Area Health Service and the hospital this week ensured additional funding.
ACON president Adrian Lovney told the Star PEP is a critical part of HIV prevention, and should not be used as a pawn in a budgetary game.
Lovney added that the issue of patients accessing PEP on multiple occasions should be addressed in counselling.
PEP needs to be administered in conjunction with appropriate counselling, he said. Clearly PEP is not intended to be and shouldn’t be used as a first-line defence. It’s not a particularly pleasant regimen to take.
