Resume PrEP, Urge Community Leaders

If you have stopped HIV PrEP in response to the COVID-19 pandemic lockdown and restrictions, community organisations are urging now is the time to ‘Resume PrEP.’

A recently published study by the Kirby Institute at UNSW Sydney found that since late March 2020 there was a steep 41.6% fall in HIV pre-exposure prophylaxis (PrEP) use among Australian gay and bisexual men. This was around the time that the first wave of Coronavirus infections hit Australian shores and the country introduced

With most parts of Australia, barring Victoria that is battling a second wave, easing restrictions community organisations are urging gay and bisexual men to consider resuming their PrEP use – either a daily regimen or on-demand.

“Australia’s success in containing COVID-19 must not be at the expense of containing epidemics such as HIV,” said Darryl O’Donnell, CEO of Australian Federation of AIDS Organisations.

The Kirby Institute’s study was led by Dr Mohamed A. Hammoud and Associate Professor Garrett Prestage. The participants were drawn from the ongoing Flux study of 3200 gay and bisexual men since 2014.

 In April 2020, around 847 HIV-negative and untested participants completed an online questionnaire that looked at the change in PrEP use as a result of COVID-19 health response.

The study revealed that in 2015 around 4.9% of the participants were on PrEP, a figure which had risen to 47.2% in 2020. Recently though approximately  41.8% of PrEP users said they had discontinued its use during the pandemic lockdowns.

The public health advice during the lockdown was to avoid casual sex. That message seemed to have worked with a related Kirby Institute study published in July by Dr Hammoud’s team showing an 84% drop in casual sex had by gay and bisexual men in Australia since the start of the pandemic.

“By April 2020, following the introduction of COVID-19 restrictions, gay and bisexual men dramatically reduced PrEP use, coinciding with a reduction in sexual activity. Since 2014, we’ve seen a steady increase in PrEP use among gay and bisexual men in Australia. The impact of COVID-19 restrictions has dramatically impacted this upward trajectory. Many men are likely making informed decisions about when to use or not use PrEP. While this research also shows us that casual sex has decreased since COVID-19, condomless sex with casual partners is still the primary risk for HIV among gay men if it isn’t protected by PrEP or HIV treatments,” Dr Hammoud said in a statement.

 Community health organisations are keen to drive that message home.

“With restrictions easing, it’s vital that men resume PrEP in a way that works for them – whether that’s returning to a daily regimen or on-demand. If they have questions about these regimens they should talk to their PrEP prescriber. We urge men in our communities to continue using HIV prevention strategies and to get tested regularly,” said Nicolas Parkhill, CEO, ACON.

Simon Ruth, CEO Thorne Harbour Health agrees that the priority is to “ensure men who took breaks from PrEP fully understand how to recommence prior to potential HIV exposure.”

Find more information on PrEP as a HIV prevention strategy visit Thorne Harbour Health  and ACON’s Ending HIV campaign.