THE Queensland Health Minister has not ruled out an expansion to the state’s current PrEP trial in light of recent expansions in NSW and Victoria.
The news comes as Queensland AIDS Council’s (QuAC) executive director said the state ran the risk of falling behind with access to PrEP and would struggle to meet national targets of zero new transmissions of HIV by 2020.
Scott has called on the government to either match or improve on the Victorian expansion or the increase to NSW’s PrEP trials announced on World AIDS Day. PrEP — medical treatment that prevents the transmission of HIV if taken as prescribed — has been heralded as a “game-changer” in the fight against the virus.
“PrEP works, we know this already. With no movement at a federal level on PrEP, we must find solutions to make PrEP available at a state level now, not several years into the future,” Scott said.
“I do not want the situation in 2020 where we knew we had mechanisms to prevent HIV transmission in 2016, but did nothing in Queensland because it was too hard.
“We need widespread access to PrEP now not only to meet 2020 targets, but because it is morally and ethically responsible to provide every means to reduce HIV transmission to Queenslanders now and in the future.”
Queensland currently has a PrEP trial underway, which is run in conjunction between the state Department of Health and HIV Foundation Queensland, but with space for only 150 participants, Scott said access to the treatment remains “patchy” and that many Queenslanders would not be able to benefit from it.
“We are falling behind because the current trials are not extensive enough to reach a critical mass,” Scott told the Star Observer.
“Thousands of men need to be accessing PrEP across Queensland to be effective at a population level. Currently the numbers of trial participants allocated for each clinic are minimal, hence many people who should be accessing PrEP through a trial are missing out.”
While the QPrEP trial is being conducted by several sexual health clinics throughout the state from Brisbane to Cairns, Scott believes more organisations within the state’s HIV sector need to be included in an expanded trial.
“QuAC should be, and is willing to be an equal partner in an expanded trial, and we have extensive expertise, leadership and advocacy to provide to ensure an expanded trial reaches the right people,” he said.
“There needs to be far greater collaboration within the sector, and any expanded trial should not be attached to one organisation.
“Victoria’s expanded trial is a joint partnership between the Victorian Government, Alfred Health, the Burnett Institute and Victorian AIDS Council. For this to work in Queensland we would need a similar partnership to form in Queensland.”
Again pointing to successes in other states, Scott believes a unified effort is fundamental to an effective rollout of PrEP in Queensland and that QuAC’s 30 year-experience could contribute significantly.
“It is important to note, that in other states, the expanded trial has replaced trails already in place, and we would expect something similar to happen in Queensland. This way, there is only one trial not a series of trials,” Scott said.
“QuAC needs to be an equal partner in the trial, to provide leadership, advocacy and expertise, not just an add on organisation to get numbers of gay men on the trial.”
Scott believes the state Health Minister is well aware of the advantages that PrEP offers in reducing new HIV transmission rates, but he is not clear on his plans regarding a possible expansion — hence his call to action.
“I presented a session at Parliament on December 1st 2015 and discussed the benefits of PrEP to a range of Members of Parliament,” Scott said.
“Throughout the session, the minister spoke of his interest in PrEP within Queensland. I am unsure as to yet whether the Minister is open to expanding the trial.”
Speaking to the Star Observer, Dick said there may be room to expand PrEP trials in Queensland.
“Our government recognises the valuable role PrEP can play in strengthening our chance of further reducing the number of new HIV cases we see in Queensland,” Dick said.
“That is why our government has invested $250,000 for a demonstration project in six places across our state, from Cairns to Brisbane.
“Our government has not ruled out the possibility of expanding our PrEP demonstration project.
“But the best way for PrEP to become widely available and accessible to those who need it is through its approval by the Therapeutic Goods Administration and listing on the Pharmaceutical Benefits Scheme.”