This presentation on research about HIV self-testing in Australia was given by A/Prof Rebecca Guy, The Kirby Institute, at the AFAO Members Forum - May 2015.
Gabriel Wagner, MD
Assistant Professor of Medicine
Division of Infectious Diseases & Global Public Health
Department of Medicine
University of California, San Diego
Iowa TelePrEP: Delivering PrEP through Telemedicine and Public Health Partner...YTH
Telemedicine is a collection of means or methods for enhancing health care, public health and health education delivery and support using telecommunications technologies. With more than 95% of adults, and 100% of young adults between the age of 18-29 owning a cell phone in the United States, a technology-based health intervention can be available to hard-to-reach populations or underserved areas.
Panelists will engage a rich dialogue and showcase innovative and effective ways to create prevention programs for HIV and STDs using the potential telehealth can offer, specifically with linking young people to HIV pre-exposure prophylaxis, or PrEP. This plenary brings together leaders in the field of HIV prevention, research and policy along with private organizations and companies that are currently active on the field of biomedical prevention.
Expert panelists:
Dr. Tafadzwa Chakare, Technical Director, Jhpiego, Lesotho
Dr. More Mungati, STAR-L Director, EGPAF Lesotho
Facilitator:
Dr. Seema Ntjabane, Care & Treatment Specialist, USAID-Lesotho
Expert Panelists: Dr. Jason Reed, Biomedical HIV Prevention
Technical Advisor, Jhpiego & Dr. More Mungati, STAR-L Director, EGPAF, Lesotho
Moderator: Dr. Seema Ntjabane, Care & Treament Specialist, USAID-Lesotho
HPTN 067/ADAPT methods and results from women in Cape TownИлья Антипин
Grant R. и др. «HPTN 067/ADAPT methods and results from women in Cape Town» 8th IAS Conference on HIV Pathogenesis, Treatment and Prevention, Vancouver, 2015. MOSY0103.
Kathleen Brady of the PDPH presented the annual report on the HIV epidemic in Philadelphia at the February 2017 meeting of the Philadelphia Ryan White Part A Planning Council.
Project RSP! Training on PrEP for HIV PreventionJim Pickett
This is a training on PrEP (pre-exposure prohylaxis) for HIV prevention, designed for people who work in the HIV prevention field. The training is designed by AIDS Foundation of Chicago's Project Ready, Set, PrEP! (RSP!). For more information on PrEP, visit the project's blog at www.myprepexperience.blogspot.com.
Dr. Kathleen Brady's presentation on PrEP (pre-exposure prophylaxis) for HIV, as given to the Philadelphia HIV Prevention Planning Group (HPG) on March 25, 2015.
This presentation on research about HIV self-testing in Australia was given by A/Prof Rebecca Guy, The Kirby Institute, at the AFAO Members Forum - May 2015.
Gabriel Wagner, MD
Assistant Professor of Medicine
Division of Infectious Diseases & Global Public Health
Department of Medicine
University of California, San Diego
Iowa TelePrEP: Delivering PrEP through Telemedicine and Public Health Partner...YTH
Telemedicine is a collection of means or methods for enhancing health care, public health and health education delivery and support using telecommunications technologies. With more than 95% of adults, and 100% of young adults between the age of 18-29 owning a cell phone in the United States, a technology-based health intervention can be available to hard-to-reach populations or underserved areas.
Panelists will engage a rich dialogue and showcase innovative and effective ways to create prevention programs for HIV and STDs using the potential telehealth can offer, specifically with linking young people to HIV pre-exposure prophylaxis, or PrEP. This plenary brings together leaders in the field of HIV prevention, research and policy along with private organizations and companies that are currently active on the field of biomedical prevention.
Expert panelists:
Dr. Tafadzwa Chakare, Technical Director, Jhpiego, Lesotho
Dr. More Mungati, STAR-L Director, EGPAF Lesotho
Facilitator:
Dr. Seema Ntjabane, Care & Treatment Specialist, USAID-Lesotho
Expert Panelists: Dr. Jason Reed, Biomedical HIV Prevention
Technical Advisor, Jhpiego & Dr. More Mungati, STAR-L Director, EGPAF, Lesotho
Moderator: Dr. Seema Ntjabane, Care & Treament Specialist, USAID-Lesotho
HPTN 067/ADAPT methods and results from women in Cape TownИлья Антипин
Grant R. и др. «HPTN 067/ADAPT methods and results from women in Cape Town» 8th IAS Conference on HIV Pathogenesis, Treatment and Prevention, Vancouver, 2015. MOSY0103.
Kathleen Brady of the PDPH presented the annual report on the HIV epidemic in Philadelphia at the February 2017 meeting of the Philadelphia Ryan White Part A Planning Council.
Project RSP! Training on PrEP for HIV PreventionJim Pickett
This is a training on PrEP (pre-exposure prohylaxis) for HIV prevention, designed for people who work in the HIV prevention field. The training is designed by AIDS Foundation of Chicago's Project Ready, Set, PrEP! (RSP!). For more information on PrEP, visit the project's blog at www.myprepexperience.blogspot.com.
Dr. Kathleen Brady's presentation on PrEP (pre-exposure prophylaxis) for HIV, as given to the Philadelphia HIV Prevention Planning Group (HPG) on March 25, 2015.
Jill Blumenthal, MD
Assistant Professor of Medicine
Division of Infectious Diseases and Global Public Health
Department of Medicine
University of California, San Diego
Project RSP! Training on PrEP for HIV PreventionJim Pickett
June 11 - UPDATED training on PrEP for HIV prevention from Chicago's Project Ready, Set, PrEP! (RSP!). Visit the Project RSP!'s My PrEP Experience blog at www.myprepexperience.blogspot.com for more informational resources, including the personal stories of individuals who have chosen to use PrEP.
Clinical Impact of New HIV Data From CROI 2019hivlifeinfo
March 4-7, 2019; Seattle, Washington
In this downloadable slideset, expert faculty members summarize key studies from this important annual conference.
Format: Microsoft PowerPoint (.ppt)
File Size: 576 KB
Released: March 22, 2019
An overview of knowledge and use of PrEP among gay men in Australia.
This presentation was given by Dean Murphy, AFAO HIV Education Officer, at the AFAO National HIV Forum, 17 October 2014.
Случаи и разногласия по ВИЧ в 2019 году: европейские перспективы / Cases and...hivlifeinfo
Learn unique perspectives across Europe on PrEP, rapid ART initiation, ART in women, and options for switching ART.
Format: Microsoft PowerPoint (.ppt)
File Size: 1.33 MB
Released: July 10, 2019
Gabriel Wagner, MD
Associate Clinical Professor
Division of Infectious Diseases & Global Public Health
Department of Medicine
University of California, San Diego
HIV Prevention: Combating PrEP Implementation ChallengesCHC Connecticut
Expert faculty present case-based scenarios illustrating common challenges to integrating HIV PrEP in primary care. As part of improving clinical workforce development, this session will delve into a variety of specific PrEP implementation challenges. Participants will leave with strategies to overcome these obstacles to establish or strengthen their PrEP program.
Panelists:
• Marwan Haddad, MD, MPH, AAHIVS, Medical Director, Center for Key Populations, Community Health Center, Inc.,
• Jeannie McIntosh, APRN, FNP-C, AAHIVS, Family Nurse Practitioner, Center for Key Populations, Community Health Center, Inc.
At the end of the training, participants will be able to:
State the indications for PrEP
State the eligibility for PrEP
Name the 5 main eligibility criteria for PrEP
Explain how to exclude Acute HIV Infection
Join us as we discuss best practices for integrating HIV prevention (e.g. HIV testing, PrEP and linkage to care) into primary care within the context of enhancing clinical workforce development.
Panelists:
• Marwan Haddad, MD, MPH, AAHIVS, Medical Director, Center for Key Populations, Community Health Center, Inc.
• Jeannie McIntosh, APRN, FNP-C, AAHIVS, Family Nurse Practitioner, Center for Key Populations, Community Health Center, Inc.
Provides information on pre-exposure prophylaxis (PrEP) to prevent HIV acquisition, including clinical recommendations and key points regarding PrEP efficacy and candidates, contraindications, lab testing, prescription, and monitoring PrEP.
Find more information at https://www.hivguidelines.org/prep-for-prevention/prep-to-prevent-hiv/
Sponsored by the New York State Department of Health (NYSDOH) AIDS Institute (AI) and the HIV Clinical Guidelines Program
Lizzy Schmidt, Director of the Woman's Program at Philadelphia FIGHT's Jonathan Lax Center, presented on HIV Treatment and PrEP at the June 2015 Ryan White Part A Planning Council meeting.
Project RSP Training on PrEP - July 31, 2015Jim Pickett
This PrEP training - a collaboration between AIDS Foundation of Chicago and the Chicago Department of Public Health - was provided to members of Chicago's HIV workforce on Friday, July 31, 2015.
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This presentation on AFAO's recent work with Culturally and Linguistically Diverse (CALD) communities was given by Michael Frommer at the SiREN Symposium in Perth, June 2016.
Scott McGill discusses ASHM's plan for developing online health promotion resources for people from CALD backgrounds. This presentation was given at AFAO's HIV and Mobility Forum in May 2016.
Darryl O’Donnell, Executive Director of AFAO, outlines changes to the organisation and sets out its priorities for 2016/17. In this context, he invited input on AFAO's future policy work from from participants at AFAO's HIV and Mobility Forum on 30 May 2016.
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Drawing upon HIV surveillance data and the Seroconversion Study, this presentation explores reasons for late diagnosis of HIV and barriers to testing among gay men and other MSM in Australia. The presentation was given by Phillip Keen from the Kirby Institute at AFAO's National Gay Men's HIV Health Promotion Conference in April 2016.
In 2015, AFAO developed a directory of health promotion programs and resources related to HIV and culturally and linguistically diverse communities. This presentation outlines how the directory was developed and can be used. This presentation was given by Jill Sergeant at AFAO's National Gay Men's HIV Health Promotion Conference in April 2016.
A report on findings from the AHOD Temporary Resident Access Study, which looked at access to HIV treatments for people not eligible for Medicare. This presentation was given at the AFAO Community Hub at the ASHM 2015 conference.
Lea Narciso from SA Health discusses the changing epidemic in South Australia, which now includes an increasing number of people born overseas, and the government's policy response. This presentation was given at the AFAO Community Hub at the ASHM 2015 conference.
This Report Card provides an overview of national momentum on HIV and mobility, highlighting areas with strong momentum and areas that are limited. This presentation was given at the AFAO Community Hub at the ASHM 2015 conference.
ComePrepd is the Queensland AIDS Councils (QuAC) new campaign for pre-exposure prophylaxis (PrEP) which aims to encourage open discussion in the gay community. This presentation discusses the design of the campaign and its various stages. This presentation was given at the AFAO Community Hub at the ASHM 2015 conference.
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
4. PrEP effectiveness
a. In intent-to-treat analyses b. In individuals with detectable levels of
TDF/FTC in blood
Source: Plenary presentation by Raphael Landovitz on 23 February 2015
5. What do we know from placebo-
controlled clinical trials of PrEP?
PrEP trials have not seen major short-term issues with:
• Risk compensation
however observation and counselling were intensive, presence of placebo
• Drug resistance
however adherence was too poor to develop drug resistant virus
• Safety and tolerability of Truvada when used by HIV negative
people
however trials enrolled healthy participants, their observation was relatively short
Still need evidence for long-term users of daily PrEP
6. What do we know from placebo-
controlled clinical trials of PrEP?
7. CROI 2015: New evidence from PROUD
• Study aim: To determine whether PrEP worked as well in the
UK as in iPrEx (44% risk reduction in HIV)
• Assumption: effectiveness may be lower in real world because:
– Adherence levels are lower
– Behavior is riskier
• Study design:
– “as close to real world as possible”
– Randomisation to “Truvada now” and “Truvada AFTER 12 months” arms
(randomised treatment stopped in October 2014, all patients continuing on Truvada)
Source: Oral presentation by Chief Investigator Sheena McCormack on 24 February 2015
8. CROI 2015: New evidence from PROUD
STI levels: very high, no difference between study arms
Risk behaviour: no significant difference between arms
Source: Oral presentation by Chief Investigator Sheena McCormack on 24 February 2015
9. CROI 2015: New evidence from iPERGAY
Source: Oral presentation by Chief Investigator Jean Michel Molina on 24 February 2015
10. CROI 2015: New evidence from iPERGAY
• HIV incidence in the placebo arm: higher than expected
• PEP: 48 participants (12%), 25 in the TDF/FTC and 23 in the placebo arm (p=0.73)
• Incidence of STI: very high, no difference between groups
• Sexual behaviour: median # sexual acts/month -10 in both arms, stable,
~70% having unprotected anal intercourse
• Median number of pills/month (IQR): 16 (10-23) in the placebo arm
16 (12-24) in the TDF/FTC arm (p=0.84)
Source: Oral presentation by Chief Investigator Jean Michel Molina on 24 February 2015
11. iPERGAY and PROUD conclusions:
• Both studies enrolled very high risk participants
• HIV incidence in control arms was very high, despite the use of PEP
• STIs: high incidence, no evidence of difference between study arms
• Concerns about PrEP being less effective were unfounded
• Daily PrEP is effective in very high-risk individuals
• Evidence about intermittent (on demand) PrEP insufficient to make
judgement
• CDC Statement on 24 February 2015:
CDC continues to recommend daily dosing of PrEP
12. What does the future hold for PrEP?
Other ongoing trials:
• Alternative schedules of PrEP use – HPTN 069
• Long acting therapies
– Rilpivirine (TMC278) – HPTN 078
– Cabotegravir (GSK1265744) – HPTN 077/ECLAR
• Combinations of interventions
13. Why do we need PrEP?
• PrEP is one of the most efficacious interventions we
have so far
• Ideal prevention intervention for:
– High risk homosexual men
– Injecting drug users
– Some high risk heterosexuals
• Ambitious targets for HIV prevention VS reality
– Global target: reduce sexual transmission by 50% by 2015
and eliminate by 2020
– Reality: In the last decade, increasing HIV incidence in
homosexual men in almost all settings (except San
Francisco, US)
14. PrEP policy in Australia
• Truvada not yet approved by TGA as PrEP (application lodged
by Gilead Sciences in March 2015)
• PrEP Guidelines:
• October 2014 - interim NSW PrEP guidelines (to guide the
NSW PrEP demonstration project PRELUDE)
• February 2015 - national guidelines for PrEP
implementation
16. Defining behavioural eligibility for PrEP: factors associated
with the highest HIV incidence in NSW (HIM study, 2001-2007)
Risk factor Associated HIV incidence
(95% CI)
All patients regardless of practices 0.78 per 100 PY (0.59-1.02)
Regular sexual partner of an HIV-infected man with whom
condoms were not consistently used in the last 3 months
5.36 per 100 PY (2.78-10.25)
>1 episode of receptive unprotected anal intercourse (UAI)
with any casual HIV-infected male partner or a male partner
of unknown HIV status during the last 3 months;
2.31 per 100PY (1.48-3.63)
Rectal gonorrhoea diagnosis 7.01 per 100PY (2.26-21.74)
Rectal chlamydia diagnosis 3.57 per 100PY (1.34-9.52)
Methamphetamine use 1.89 per 100PY (1.25-2.84)
>1 one episode of anal intercourse during the last 3 months
when proper condom use was not achieved (e.g., condoms
slipped off or broke)
1.30 per 100 PY (0.95-1.77)
>1 episode of insertive UAI where the serostatus of partner
was not known or was HIV positive and not on treatment in
the last 3 months
0.94 per 100 PY (0.35-2.52)
- In circumcised men 0.65 per 100PY (0.16-2.61)
- In uncircumcised men 1.73 per 100PY (0.43-6.90)
17. Defining behavioural eligibility: MSM
High risk - recommend prescribing daily PrEP if the client acknowledges:
being likely to have multiple events of unprotected anal intercourse (UAI), (+/-sharing IDU), in the next 3 months (indicating
sustained risk)
AND
Having any of the following:
• Regular sexual partner of an HIV-infected man with whom condoms were not consistently used in the last 3 months (HIV
positive partner is not on treatment and/or has detectable viral load);
• At least one episode of receptive UAI with any casual HIV-infected male partner or a male partner of unknown HIV status
in the last 3 months;
• Rectal gonorrhoea or chlamydia diagnosis during the last 3 months or at screening;
• Methamphetamine use in the last 3 months
Medium risk - consider prescribing daily PrEP if the client acknowledges:
being likely to have multiple events of UAI (+/-sharing IDU) in the next 3 months (indicating sustained risk)
AND
Having any of the following:
• More than one episode of anal intercourse in the last 3 months when proper condom use was not achieved (e.g.,
condoms slipped off or broke);
• if client is uncircumcised and reports more than one episode of insertive CLAI in the last 3 months where the
serostatus of partner was not known or was HIV positive and not on treatment.
Note: MSM who have only infrequent exposures to HIV (e.g., an occasional broken condom or lapse in condom use) may be good candidates for nPEP
rather than PrEP. These men, as well as men who fall into low risk category C, should be educated about safer sex strategies, nPEP and PrEP, and decision
about PrEP use should be made on a case by case basis.
18. Access to and use of PrEP in NSW
I. Informal use
– recorded by Sydney Gay Community Periodic Surveys since 2011 @ about 2.5%
– Schedule of use: unknown
– Sources of medication: varying
II. PrEP demonstration projects
– NSW (300 participants)
– Victoria (100 participants)
– Queensland (50 participants)
III. PrEP prescribing outside demonstration studies
– Levels of prescribing: unknown
– Schedule of use: daily per national guidelines
– Source of medication: purchase online or overseas with self-importation
19. Demonstration project PRELUDE
AIM:
• Develop and evaluate a model of evidence-based delivery of PrEP as part
of HIV prevention strategy in NSW
Progress to date:
• Stage I:
• Sydney Sexual Health (enrolling)
• St Vincent’s Hospital (enrolling)
• Western Sydney Sexual Health Clinic (enrolling)
• RPA Sexual Health (enrolling)
• Stage II:
• Holdsworth House (enrolling)
• Taylor Square (enrolling)
• Newcastle Community Health Services (approval process)
• Clinic 16 (approval process)
• We collect information about all services provided to PrEP users per
guidelines and additional services requested by clinicians (when
necessary) – to assess the amount and cost of services for PrEP users)
20. Demonstration project PRELUDE
AIM:
• Assess the acceptability of PrEP among clients at high risk for HIV (overall
uptake by individuals offered PrEP; reasons for declining PrEP, patterns of
use, self-reported preferences for alternative schedules and/or duration of
PrEP use).
Progress to date:
• # participants enrolled: ~170 out of 300
• First participants reached 6 months of follow-up
• Only 3 people stopped PrEP (all @ 1 month)
• Self-reported willingness to take PrEP for >12 months (at baseline):
96%
• Patterns of use: once daily Truvada pill
21. Demonstration project PRELUDE
• Cohort of very high-risk participants
• Expected HIV incidence (using indicators from HIM study):
1.7 – 7.0 per 100 PY
• Adherence to PrEP and safety issues:
– At this early stage, no major issues with adherence
– No HIV seroconversions
– No drug related serious adverse events
– Most common side-effects: Nausea (7), diarrhea (6), fatigues (6), headache (5) – none that stopped PrEP
– STI incidence:
• Chlamydia detected at baseline – 18, FU1 – 5
• Gonorrhea detected at baseline – 12, FU1 – 0
• Syphilis detected at baseline – 2, FU1 – 1
Important issue to consider in PrEP users: treatment/prophylaxis of STIs
22. Current and future of PrEP in Australia
• Undeniably, PrEP is an efficacious HIV prevention strategy
• Australia is only the 3rd country to have national PrEP guidance
• PrEP is already part of our HIV prevention work
• Strong community advocacy and provider interest to PrEP
• Work is ongoing on establishing and evaluating our new standard of care
PrEP services
• Issues to consider:
• Growing demand for PrEP
• access to and cost of PrEP in Australia
23. Acknowledgements
• Sheena McCormack (PROUD) and Jean-Michel Molina
(iPERGAY) for sharing slides
• PrEP guideline development group (NSW)
• PrEP guideline development group (ASHM)
• NSW Ministry of Health - for funding evaluation research on PrEP
• Gilead Sciences - for providing the study medication TRUVADA
• NSW partner organisations (ACON, Positive Life) – for active
support of PrEP evaluation research
• NSW and ASHM PrEP expert policy development groups
• Clinics participating in the PRELUDE study
• PRELUDE study investigators and management team
• Study participants: PRELUDE study and other research on PrEP