HIV pre-exposure prophylaxis (PrEP) is highly effective at reducing HIV transmission  in high-risk populations.

HIV PrEP is available on the Pharmaceutical Benefits Scheme (PBS) via streamlined S85 monthly prescription. Any medical practitioner or qualified nurse practitioner can prescribe up to three months’ supply.In Australia, the single-tablet tenofovir disoproxil + emtricitabine (TDF/FTC) is used for HIV PrEP. Renal and BMD risks are rare for people with no preexisting renal or bone disease.

PrEP can be offered to anyone with any HIV risk.

Do you prescribe PrEP? 

You can add yourself to this interactive map through PrEP Access Now to help people locate you.

https://www.pan.org.au/find-a-doctor

This is another useful resource:

https://docdir.org.au/

Prescribing PrEP

Initiation

• Consider PEP if risk of HIV exposure within the last 72 hours
• EUC , confirm renal function meets guideline requirements (EGFR>60) -see ASHM Decision-Making Tool 
• STI screen (throat and rectal swab + urine)
• Perform hepatitis B serology, if status unknown, and vaccinate if not immune
• HCV antibody

3-Monthly monitoring while on PrEP

• HIV and syphilis serology
• STI screen
• EUC 6-monthly renal function

            For details, see ASHM Decision-Making Tool 

We support ame day prescribing of PrEP continuation in people attending  regularly for STI/HIV ? without needing to return for negative results

PrEP dosing options

Daily PrEP

• Suitable for anyone

Commence with double dose (2 tablets) for immediate protection, then one tablet daily. On-Demand

• Onlysuitable for cis-gender men who have sex with men
• Not suitable for people who inject drugs or transgender people
• Take 2 tablets at least 2 - 24 hours before sex then 1 tablet 24 hours after first dose) & 1 tablet 48 hours after  first dose
• Diagrams and patient information

Medicare eligible: PBS Information 

• Prescribe Tenofovir disoproxil + emtricitabine (TDF/FTC)
• PBS General Schedule “Restricted Benefit” - no authority required
• 30 tablets X 2 repeats
• Any medical officer or nurse practitioner can prescribe
• Truvada^®is no longer available on the PBS, it has been replaced by generics

Medicare ineligible

• PrEP can be ordered and legally imported into Australiawith a valid prescription
• Prescribe Tenofovir disoproxil + emtricitabine (TDF/FTC) 90 tablets with up to 3 repeats
• For a list of online pharmacies

Questions? Clarifications? Contact NSW Sexual Health InfoLink 

Resources

• Decision-Making in HIV PrEP Tool
• HIV PrEP Guidelines
• HIV PrEP - How to Take PrEP - On Demand
• HIV PrEP PBS Listing

• ASHM Online Learning Module - PrEP prescribing in general practice (free) 

Selected References

• PROUD Study 
• IPERGAY Trial 

_{The Sexual Health Service makes every effort to make sure the information on this website is accurate and up to date. The guideline does not replace the need for specialist medical advice in individual cases.}