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Qld PrEP trials set to recruit HIV negative men
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Qld PrEP trials set to recruit HIV negative men

LAST UPDATED // Wednesday, 29 April 2015 12:53 Written by // Andrew Shaw

Last night’s forum in Brisbane hosted by the HIV Foundation Qld explored the growing demand for PrEP.

Introduced by Heath Paynter from the Victorian AIDS Council, HIV specialists Dr Andrew Redmond, Dr Fiona Bisshop and Cairns Sexual Health Centre clinical nurse consultant Simon Doyle-Adams gave frank and expert opinions to an audience of LGBTI community members.

The foundation is about to embark on QPrEP, a combination of a clinical trial and sexual health research that will look at the feasibility of providing PrEP through S100 clinics – those clinics authorised to prescribe HIV medication.

There will be 50 places in the trial for men who have sex with men, who are HIV negative and who have had unprotected sex with an HIV positive man in the last three months.

Places will be offered on a “first come, first served” basis and the trial is expected to begin in June.

PrEP or Pre-Exposure Prophylaxis, is a daily course of medication, specifically Truvada, taken by HIV negative people that greatly reduces their chances of becoming HIV positive.

Since Truvada is not approved for PrEP in Australia, it is not available on the Pharmaceutical Benefits Scheme (PBS) which means it cannot be government subsidised.

It was suggested it could be two years before Australia approves Truvada for PrEP.

The issue of whether the federal government will add Truvada for PrEP to the PBS was not discussed.

Dr Andrew Redmond spoke of the seven international randomised controlled trials of PrEP.

While some results showed PrEP was effective in 86 per cent of cases of blocking HIV transmission, those in African countries showed in some cases negative results.

Redmond pointed out that adherence to taking the drug played a large part in these poor results.

“The effectiveness of PrEP is probably even higher than the 86 per cent effectiveness shown in the two best outcomes,” Redmond said.

Speaking of the side-effects of Truvada, he said there was generally a one to two per cent reduction in renal function.

Dr Fiona Bisshop said if PrEP was adhered to, side effects were not debilitating.

She pointed out that cost was an obstacle to PrEP.

PrEP on private prescription costs approximately $10,000 per year, although it can be bought from overseas for $1,300 per year.

Instructions on how to access generic Truvada for PrEP online through the site www.aidsdrugsonline.net were provided to attendees.

“We need PrEP because HIV rates are rising, condoms don’t work for all people, and people are already using it,” Bisshop said.

“It does not lead to more condomless sex, and it doesn’t lead to more STIs.”

Along with other members of the panel, Bisshop stressed the importance of being HIV negative when starting on PrEP.

“If you go on PrEP when you are HIV positive it’s a nightmare to treat,” she said.

She said the term “Truvada whore” was invalid, since PrEP was about people protecting themselves.

She said sex workers whose clients wanted condomless sex, serodiscordant partners, meth users, and those people with multiple sexual partners should be offered PrEP.

“The key is not to have HIV when you start taking PrEP. There is a potential for resistance to develop if PrEP continues after you become HIV positive.”

Simon Doyle-Adams focused on the implementation of PrEP in Queensland, outlining that seven sites are expected to participate in the trial, which will begin recruiting soon.

For more information go to http://hivfoundation.org.au/about-hiv/prevention

[image] Dr Fiona Bisshop, Dr Andrew Redmond, Simon Doyle-Adams and Simon O’Connor from Queensland Positive People. Photo: A Shaw.

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Andrew Shaw

Andrew Shaw

Andrew Shaw is editor of QP [queensland pride magazine].

Comments (2)

  • GoodIdea

    04 May 2015 at 01:26 |
    As long as people with HIV are taking antiretrovirals correctly, they are unable to spread the disease and are rendered uninfectious. This medication literally stops HIV from entering cells - so to have increased quantities circulating in the broader community means less overall transmission, and once transmission rates are slowed, a disease enters terminal decline. It's a good long term strategy when used in tandem with encouraging EVERYONE to get tested as often as possible via convenient, simple, free walk-in clinics. Humans will always have unprotected sex (not just gay people - you would be shocked at how blasé many women are when taking oral contraceptives!), and with the advent of effective treatment, relying on fear alone to encourage people to use condoms is no longer as effective. This is reflected in rising rates of transmission, particularly amongst the young who aren't as scarred by the effects of the AIDS epidemic in the 80's and 90's. In fact relying on fear might be counteractive as this same fear prevents many people from being tested, so if they have HIV, they continue to spread it. So you have one cohort of people who aren't scared of HIV and having unprotected sex, and another cohort who are too scared to be tested and are spreading it. This is obviously a recipe for disaster! A unified strategy is necessary.

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  • notsureabouthis

    24 March 2015 at 18:20 |
    Yeah I'm not sure Dr Bisshop is being totally realistic! You are dealing with men! Off course it's going to lead to more condomless sex and increase the risk of other STIs. How can she say that it won't?? Men are men and are going to think it's great not having to use a condom because they are supposedly protected from HIV. But they aren't protected from other STIs are they?? I just don't get how the doctor can make a claim like that and not be concerned about an increase of gonorrhoeae, syphilis and chlamydia from condomless sex. Anyway, only time will tell.

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