What is PrEP?

PrEP is a new HIV prevention method in which people who do not have HIV infection take a pill daily to reduce their risk of becoming HIV infected.

The pill is called Truvada and it contains two antiviral medicines that are also used to treat people who are already living with HIV (PLHIV). These are the same drugs used to suppress the virus in PLHIV. “PrEP” stands for Pre-Exposure Prophylaxis, with “prophylaxis” meaning “to prevent or control the spread of an infection or disease.”

Who should take PrEP?

The effectiveness of using HIV antiretroviral drugs as PrEP has been established by clinical trials conducted in gay men, heterosexual adults and injecting drug users. PrEP can be considered for people in these populations who are at high risk of acquiring HIV, such as gay and other homosexually active men who are having multiple events of condomless sex.  There is less clinical data available for people with a trans experience, but current guidelines in Australia are inclusive of this part of our community.

How does Truvada work?

If you take Truvada as prescribed and you are exposed to HIV through sex or injecting drug use, this medicine works to prevent HIV infection. PrEP can offer effective protection against HIV if taken every day. Truvada (a dual combination of the antiviral drugs tenofovir and emtricitabine) has been investigated in several major clinical trials and has shown to be highly effective as HIV pre-exposure prophylaxis, provided the medication is taken correctly.

Is Truvada available in Australia?

Truvada was licensed for use as PrEP in Australia by the Therapeutic Goods Administration (TGA) in 2016. It is not yet available at a subsidised price through Australia’s Pharmaceutical Benefits Scheme (PBS).

Following an initial unsuccessful application to the PBS, community and medical organisations have been urging the relevant pharmaceutical company to make another application as soon as possible. However, a successful listing on any such applications would be unlikely until at least 12 months after lodgement.

What are the options for obtaining PrEP?

If you are considering PrEP, you should discuss this with a doctor experienced in HIV or sexual health to help decide if PrEP is right for you.

This factsheet explains your options for obtaining PrEP through the Australian health system, and how to go about obtaining generic Truvada via the internet if you and your doctor decide that is your best access option.

Ask your doctor about the possibility of getting Truvada through access programs operating in some Australian states and territories. Places in these programs are limited. Truvada is usually free in these access programs – although a dispensing fee may be charged as for most PBS listed medicines. In NSW, there is a study called EPIC-NSW which is currently enrolling participants.

Your doctor can also prescribe brand name Truvada from local supplier, Gilead Sciences Australia. The cost is over $10,000 for a year’s supply of Truvada, which will be too expensive for most people.

If you are not able to access PrEP through a study, another much more affordable option is to purchase a generic version of Truvada from a reliable overseas supplier. Generics are low cost alternatives to brand name drugs but contain the same active components.

The cost of generic PrEP is much less than brand name Truvada and would be approximately $600 to $1300 per year, which will still be too expensive for some, but an option for others.

Australia's personal importation scheme for medicines (IPU)

You can legally import most medicines for your personal use under Australia’s personal importation scheme. This involves arranging from within Australia for a medicine to be sent to you from an overseas supplier or family/friend. The medicines are only to be used by you (or a member of your immediate family) and must not be supplied to any other person. It is important to note that such medicines may not be approved for supply in Australia by the TGA.

The TGA warns there are no guarantees about their safety or quality. Subject to satisfying various conditions you may import a three month supply (at the maximum dose recommended by the manufacturer) of an unapproved medicine without any prior approval required by the TGA.

To purchase or import a generic version of Truvada into Australia, you must first get a valid Australian issued prescription to accompany the medicine being imported. It is recommended to see a doctor skilled in sexual health and HIV in obtaining a generic PrEP script.

Obtaining generic Truvada online for PrEP?

If you and your doctor decide that obtaining generic PrEP online is the best option for you, there are a variety of suppliers and resources available to guide you through this process.

Buying medicines online

The internet can offer consumers a convenient and less expensive way to access medicines. However, online purchases of medicines must be approached with caution. Medicines available on international websites are not regulated by the TGA.

You need to ensure that the website is legitimate, otherwise consumers face risks, including that medicines are fake, past their use-by date or not manufactured to appropriate standards. Medical guidance from the internet should never replace consultation with your doctor and should be interpreted with caution.

How to order generic Truvada for PrEP Online

Please be aware that generic Truvada comes in a different names including Tenvir EM, Adco-Emtevir or Ricovir EM. There are multiple suppliers who export PrEP into Australia at a range of costs.

A community-based organisation, PAN (PrEPaccessNOW) was created to assist Australians with accessing PrEP, including through personal importation from overseas suppliers. They provide detailed information on various suppliers, the costs and which generic is used.

If you have any questions about generics, please be sure to discuss these with your doctor when getting your prescription. Visit website: pan.org.au

Where can I find out more?

For more information on importing medicines for personal use see the Australian Government’s Therapeutic Goods Administration (TGA) website: tga.gov.au/importing-mail-or-courier

For more information on PrEP, contact your local HIV organisation, your doctor or sexual health clinic. endinghiv.org.au/prep

pdfPrEP Access Options

In NSW, the community based organisations that can assist with information about PrEP, eligibility and steps to access PrEP are:

Positive Life NSW
(02) 9206 2177
1800 245 677 (freecall)

(02) 9206 2000
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Givenow - make a secure online donation to Positive Life NSWLocation: Suite 5.2, Level 5, 414 Elizabeth Street, Surry Hills NSW 2010
Postal: PO Box 831, Darlinghurst NSW 1300

Telephone: 02 9206 2177 or 1800 245 677 (freecall)
TTY: 131 450    Fax: 02 9211 5672

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