21 March 2018
ASHM congratulates the Federal Health Minister, the Hon. Greg Hunt’s announcement of a landmark in HIV prevention to approve HIV-prevention drugs – tenofovir with emtricitabine, known as PrEP – on the Pharmaceutical Benefits Scheme from 1 April, thereby providing broader access for any doctor or general practitioner to be able prescribe PrEP to an Australian resident who holds a current Medicare card.
“The public health benefits are clear, undeniable and transformative benefiting individuals at medium- to high-risk of HIV infection and towards driving a substantial reduction in HIV transmissions in Australia,” said ASHM President, Associate Professor Bloch.
“With this announcement of public subsidy – now is the time to support transition from more controlled clinical trial environments to real-world broad access,” continued Dr Bloch referring to the successful rollout of demonstration PrEP trials that have over two years recruited more than 14,000 participants across Australia.
“Engaging and equipping the health workforce is a key component of this strategy,” ASHM Acting-CEO, Scott McGill said. “This will require workforce development and support including readily accessible, evidence-based training and resources tailored to the needs context, level of familiarity and demands of the health provider including on-line support and information or discussion forums.”
“Primary care services less experienced in HIV or sexual health will especially need to be efficiently and appropriately trained and supported with clear referral pathways in place and the appropriate use of medicines maintained, adhering to guidelines.”
As a peak education provider, ASHM has the PrEP tools, training and resources ready to support the health workforce to step up to the incredible opportunity now afforded us, in partnership with clinicians and allied-health workers and not least consumers and community providers supported by the Federal government and states and territories and other stakeholders.
Challenges and opportunities in this PrEP-access transition need to be met head-on and tackled:
- Barriers to access for those more marginalised populations who are eligible for PrEP, such as culturally and linguistically diverse communities, Aboriginal and Torres Strait Islanders, those who are Medicare ineligible, trans and gender diverse populations and those outside of metropolitan areas need to be included to ensure equity.
- Stigma and discrimination regardless of their sources but most particularly within the workforce is entirely unacceptable and must not be a barrier for those who expect to be able to access appropriate and high-quality care – at all stages along the patient journey.
- HIV PrEP affords opportunities for more and better STI screening and management; clinicians be prepared to have proper sexual health discussions with their patients along with regular STI screening and availability of combination prevention methods. In the era of HIV PrEP, behavioural methods of risk reduction, including condom use are still important in preventing HIV infection and remain a pillar for STI prevention.
Access Links to Clinical Resources supporting the HIV workforce
ASHM, through its PrEP guidelines affirms the PBAC position, that individuals should return a negative HIV test result prior to commencing PrEP. Any individual considering PrEP should discuss this with their doctor. Any individual who is on PrEP will need three-monthly monitoring, prevention and adherence support, which will coincide with maintenance prescriptions.
- The definitions of risk for HIV, guidelines and procedures for the appropriate administration and monitoring of PrEP The definitions of risk for HIV, guidelines and procedures for the appropriate administration and monitoring of PrEP can be found in the ASHM HIV pre-exposure prophylaxis: clinical guidelines
- The Australian Federation of AIDS Organisations (AFAO) and ASHM have produced a PrEP Fact Sheet to assist PrEP users and people with an interest in using PrEP to understand what subsidised access to PrEP through the PBS means. Access the factsheet here
- ASHM continues to support the workforce to ensure access to PrEP and best practice in guidelines, training and resources. Access information here
- The Pharmaceutical Society of Australia has a range of training to support pharmacists in preparing for PrEP on the PBS. Visit www.psa.org.au
Photo: Serafim Pharmacy in Darlinghurst NSW promoting news of the availability of PrEP coming soon in their store window (left); Federal Health Minister, the Hon. Greg Hunt, and other spokespersons at the announcement of the PBS date listing today (right).
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Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) is a peak organisation of health professionals in Australia and New Zealand who work in HIV, viral hepatitis and sexually transmissible infections (STIs). ASHM draws on its experience and expertise to support the health workforce and to contribute to the sector, domestically and internationally. www.ashm.org.au