Qld PrEP trials set to recruit HIV negative men
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.