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Are gay men in Perth missing out on PrEP?

The short answer is yes and no.

The announcement recently that the Victorian Government would fund places for 2,600 people to participate in a trial that would provide them with free Pre-Exposure Prophylaxis – or PrEP – came close on the heels of the decision late last year by the New South Wales Government that it would similarly fund 3,700 places in that jurisdiction. The Queensland Government is currently considering a scheme that would offer 1,000 places.

So, on the surface it would seem that if you are a gay or homosexually active man living on the East Coast and are at risk of acquiring HIV, you have a fairly good chance to access PrEP for free. There are, after all, 7,300 potential places in total. If you live in WA, not so much.

As for Western Australia, the Kirby Institute estimates that there are 1,200 homosexually active men that would meet the guidelines (i.e. the guidelines in place in New South Wales and Victoria). However, there has still been plenty of progress here. We remain the only jurisdiction where the Government has issued an Operational Directive that means that if a patient meets criteria indicating heightened risk of acquiring HIV, they should be prescribed it. But, this means paying the un-subsidised costs of Truvada™ which amount to more than $1,000 for one month’s supply. Alternatively, they can privately import a generic version at a cost of under $100 per month. Even this will be a barrier to some who need this bio-medical prevention that research is increasingly showing as both safe and highly effective if used correctly.

Following the first PrEP forum in November, facilitated by the WA AIDS Council, it is clear that our community needs much more information about the potential benefits and access options. A second forum is scheduled for February. Meanwhile, we continue to talk to the Government about any possibility of funding for a PrEP access trial. M Clinic provides information on a variety of social media and internet sites and gay men who want to think about whether PrEP is a suitable option for them can meet with trained peer educators to discuss it.

A small but growing number of gay men in WA are already privately importing the medication, but as the number of new HIV infections remains at historically high levels, it is clear that many more can benefit. We have a Government recommending its use when indicated and community resources offering expanded support. We’ve come a long way in twelve months and we have a way to go. We are behind in terms of cost, but less so in terms of access.

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To minimise the impact and further transmission of HIV, other blood borne viruses and sexually transmissible infections. To reduce social, legal and policy barriers which prevent access to health information and effective support and prevention services.