For many in the gay community PrEP or pre-exposure prophylaxis is quickly becoming a hot topic issue when it comes to discussions of HIV and safe sex. The drug more commonly known as Truvada has only come to mainstream attention in the past 5 years or so, marketed as a 99% effective preventative treatment against HIV infection.
With over of half of the 27,000 HIV cases in Australia occurring from male-on-male sexual contact, questions are being asked about the efficacy of Truvada, how to get the drug and what limitations surround it. We’ve taken a crack at answering the most common concerns, so you can decide for yourself.
How does PrEP Work?
PrEP works in pretty much the same way regular treatments do for HIV positive individuals. In those cases patients use a combination of powerful antiretroviral drugs to stop the virus from replicating in the body’s immune cells. PrEP mirrors this exact process in HIV negative individuals that wish to avoid the risk of infection. Truvada comes as a single pill, and just like birth control it must be taken consistently on a daily basis in order to ensure effective results, that’s regardless of whether you’re having sex or not.
Is PrEP Safe?
Generally any drug approved by international medical regulators has more benefits than drawbacks, but Truvada in particular seems to have few side effects. 1 in 10 people on the drug reported nausea, stomach aches and weight loss but these symptoms aren’t permanent and will subside if you stop taking the pill. Some studies have also shown a decrease in kidney functions and small losses in bone density, but once again these effects generally improve or disappear altogether after stopping treatment. Any doctor who prescribes Truvada will also generally ask you to check back in every three months for discussion and follow-up testing.
Can I get PrEP?
The good news is the Therapeutic Goods Administration has approved Truvada for sale in Australia. However it has not yet been added to the Pharmaceutical Benefits Scheme, which means no government subsidies on the price of the drug, making it very expensive to buy.
If you’re prepared to pay the cost then you can check out a list of prescribing physicians here, or call your state’s HIV/AIDs council. Remember, this is still a relatively new medication so doctors in your area may not yet be aware of it. A regular course of treatment for the drug is put at around $840 a month, or about $28 a day, which adds up to about $10,000 a month. Alternatively you can use your prescription to try ordering the drug online, marketplaces do exist that sell the drug as low as $53. Importing your own drugs is legal in Australia, as long as the quantity is limited to a 3 months’ supply, be careful with this method though as you’ll have no guarantee that the drug you’re buying is correct or properly regulated. Finally, you could try your hand at getting admitted into a government run trial, there are currently four running and they are primarily recruiting gay and bisexual men with high risk of infection.
Do I have to use a condom?
The question gay men are ask most often after understanding PrEP is, can I have unprotected sex on PrEP. The answer to this is very much subjective, after all your sex life is still under your control, while PrEP is proven to be anywhere from 92-99% effective, using the drug inconsistently can still put you at risk for infection.
Remember that Truvada will not protect you from other STI’s such as syphilis or Chlamydia. So, while a combination of condoms and PrEP will provide the strongest barrier against sexual risks, if you’re in a monogamous relationship, or you have strong personal reasons for not using a condom PrEP can still provide a good preventative measure against HIV.
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