MORE than a third of gay men mistakenly believe pre-exposure prophylaxis treatment – or PrEP – which prevents HIV transmission is affordable and widely available in Australia, prompting calls for the government to fast track the medications for general use.
The most recent findings from the gay community periodic surveys also show almost all Sydney men who know they are HIV-positive now have an undetectable viral load, indicating that men who are unaware they are positive may still be the drivers of HIV.
[showads ad=MREC]The periodic survey was conducted by the Centre for Social Research in Health and the Kirby Institute at the University of NSW
Around 36 per cent of gay men in Sydney who took part thought PrEP – which involves the use of medications by HIV-negative men to prevent themselves from contracting HIV – was available now, a 40 per cent-plus rise on 2014’s figures.
The results mirror those found by the survey in Melbourne.
Only 1.8 per cent of HIV-negative men are on PrEP, mostly through drug trials or having it imported via prescriptions and overseas websites. However, PrEP is not currently approved for use in Australia by the Therapeutic Goods Administration (TGA) — the country’s peak regulatory body for medicines and blood products — nor is it listed under the Pharmaceutical Benefits Scheme (PBS).
US pharmaceutical giant Gilead Sciences recently began the application process to have Truvada as PrEP approved by the TGA, which is the first step required before a PBS listing. While Truvada is already available as a medication for people living with HIV, TGA and PBS approval would allow it to also be used as a HIV prevention method and make it readily available.
Chief executive of NSW LGBTI health body ACON Nicolas Parkhill said a corresponding rise in the number of men not using condoms with casual partners meant there was now an urgent need for PrEP to be made easily accessible.
“While the bulk of gay men in NSW continue to always use condoms, there’s clearly a minority who don’t, and they’re the ones who would certainly benefit from access to PrEP, as we know that condomless anal intercourse remains the main transmission route for HIV among gay men,” he said.
“Giving our community access to PrEP is therefore vital for the success of our HIV prevention efforts in NSW and we’re currently working with all relevant stakeholders to fast track approval for the medication.”
PrEP has been available in the US since 2012.
The periodic study’s lead researcher, Associate Professor Martin Holt, said it was critical men who had unprotected sex had improved access to the medication: “PrEP is highly effective in preventing HIV, we know that men at high risk of HIV are interested in using it, and there is broad support in the gay community for greater access to it.”
The number of gay men in Sydney who are aware of the easy availability of post-exposure prophylaxis (PEP), which may reduce the chances of contracting HIV immediately after potential exposure, has dropped to around 60 per cent.
Meanwhile, the study found that nine out of 10 men who are aware they have HIV say they are now on treatment, with 96 per cent reporting an undetectable viral load. To have an undetectable viral load means a HIV-positive person is on treatment and adhering to it, effectively stopping the HIV virus from replicating. The virus is still present and dormant in their body, but it’s not detectable in blood tests and it’s also unlikely they could transmit it.
Positive Life NSW chief executive Craig Cooper said this was the most exciting news to come out of the report.
“That’s something to kick our heels about and celebrate,” he said.
“HIV positive guys are engaged with healthcare and caring for our community.”
Cooper struck a note of warning, though: “That means transmission is now generally coming from guys who assume they’re HIV-negative and they are the drivers of the epidemic Sydney.”[showads ad=FOOT]