The ASHM PrEP Guidelines have been reviewed and updated with the aim of further removing barriers to PrEP access. The guidelines have been submitted to the Blood Borne Viruses and Sexually Transmissible Infections Standing Committee for endorsement as a national guideline.  

 

Key updates include: 

 

  • Endorsement of the World Health Organisation’s recommendation that on-demand PrEP should be offered to cis-gender MSM.  

  • No longer stratifying a person’s risk of HIV acquisition as high or medium, instead collapsing these into a simplified “HIV risk”. 

  • Now recommend offering PrEP to people who only report perceived future HIV risk in the future 3 months. (E.g., people who normally have low HIV risk but are about to go travelling) 

  • Strengthened recommendation that PrEP is recommended for people whose quality of life is likely to improve if they are offered PrEP e.g. people with high anxiety about HIV acquisition 

  • Provision of a parallel chapter to assess PrEP suitability that is written for clinicians who are knowledgeable about transgender terminology and concepts. 

  • Language changed from “PrEP eligibility” to “PrEP suitability”. PrEP suitability criteria are not intended to limit or deny access to PrEP to any person who seeks it. Instead, they are intended to assist clinicians in their discussions about PrEP with patients who are not certain about whether to commence PrEP. 

  • Highlights that PrEP can be prescribed off label to adolescents, after obtaining informed consent. Adolescents can import PrEP using the Personal Importation Scheme. 

 

Dr Vincent Cornelisse presented key updates to the guidelines at the 2019 Australasian HIV AIDS Conference in Perth on behalf of the ASHM PrEP Guidelines Panel.

The Guidelines were reviewed and updated by the PrEP guidelines panel: Chair: A/Prof Edwina Wright; Dr Charlotte Bell; Dr Vincent Cornelisse; Prof Andrew Grulich; Jessica Michaels; A/Prof Darren Russell; Bill Whittaker; A/Prof Iryna Zablotska-Manos; and ASHM Secretariat: Zindia Nanver.  

Each chapter was reviewed and re-written by a small group of subject matter experts, to update according to latest evidence. Each re-written chapter was then reviewed by the broader guidelines reviewing committee comprised of clinicians, researchers and representatives of relevant community organisations and priority groups.