Dr Rosemary Chen
BMed; FRACGP
Acute IllnessAlopecia Areata TreatmentAntenatal CareChild Health ServicesChronic Disease Prevention & ManagementHIV ManagementMental HealthReproductive HealthSexual HealthTravel HealthWomen’s HealthWork Health
There was a time when polio and smallpox were real concerns of parents everywhere, and epidemics were rampant.
Those days are long behind us.
We’re now looking at a very real future where HIV infections will be a distant memory too. AIDS is already something people talk about in the past tense in Australia.
How can we end HIV? Well, there are a few little steps.
Making sure you’re tested at least annually if you’re sexually active, or up to 4 times a year if you are at higher risk is important. Check out ‘how often should I have a sexual health check?’ For more information
It used to be that we’d wait until HIV would cause someone’s immunity to drop before beginning treatment. These were when medications were new, had many side effects and people needed to be on a lot of expensive tablets.
But things have come a long way since then.
We know that by beginning treatment as soon as possible after diagnosis, we can protect against all the long-term effects and secondary issues associated with HIV. It also greatly reduces the chance of transmission through Treatment as Prevention (TasP) when a viral load is undetectable.
There are lots of things that can be done to reduce the chance of transmission.
Check out endinghiv.org.au for more information.
Pre-exposure prophylaxis (PrEP) is the use of medication by people without HIV to prevent infection.
It’s a combination of two antiretroviral medications commonly used in the treatment of HIV. It reduces the risk of HIV infection with studies showing a 99% reduction if taken every single day.
It’s most suitable for those at the highest risk of HIV infection.
While most people tolerate the medication quite well it can’t be taken to prevent HIV transmission in people.
If you are at low risk of HIV transmission, there might not be any point in taking this medication.
PrEP has proven to be an extremely effective way of preventing HIV infection if taken regularly. A study called EPIC NSW (Expanded PrEP Implementation in Communities in NSW) was implemented to provide this medication for thousands of people at risk of HIV in NSW. Green Square Health was a registered trial site, and we were enrolling eligible people.
The trial ended on the 30th of April. If you were already on PrEP via the EPIC trial, please give us a call about the medication you may be eligible for.
PrEP has been available on PBS since the 1st of April 2018. If you do not have a Medicare card you can still take PrEP via a private prescription which and then can be dispensed from a local pharmacy in Australia, or order from an online pharmacy (limited to a 3-month supply at a time). For a list of reputable online pharmacies, visit pan.org.au
For patients who hold a valid Medicare card, PrEP is available on PBS. If you are eligible (medium to high risk of HIV infection), then a bottle of 30 tablets will cost $38.50, or $5.40 if you hold a concession card.
If you don’t hold a Medicare card, there’s no reason to worry. You can legally import PrEP medication from overseas with a valid doctor’s prescription from Australia. This can range between $22-$98 a month depending on the pharmacy, and you can order 3 months’ supply at a time.
Firstly, we need to make sure there’s no reason you can’t take it, and an HIV test and Kidney function test are necessary. We also take a full STI screen at this time as well.
Once your results have returned, we issue a 1-month supply prescription initially and ask you to repeat the HIV test and Kidney function test a few days before you finish the tablets. Depending on how that month has gone, we might repeat the STI screen too.
If everything is going smoothly, we prescribe a further 2-month supply, and catch up every 3 months for an STI screen, a chat about your ongoing risk and if this has changed in any way, and make sure your kidney function is stable and remains in the healthy range. It is also a great opportunity to check in regarding your overall health, and we’re happy to discuss any urgent or non-urgent medical concerns you might have.
So, if you think PrEP might be right for you, and you want to add it to your arsenal of tools to stay safe, come chat with one of the doctors at GS Health.
Some great information about PrEP is available at https://endinghiv.org.au/nsw/stay-safe/prep/
At Green Square Health we provide the services to look after anyone living with HIV and to get the most out of their treatment.
People on medication for their HIV, often find that they see a specialist a few times a year to keep an eye on things but see their GP for their other healthcare. But at Green Square Health our doctors have undertaken the extra training and have the experience to help diagnose, treat and manage HIV infections.
Progress has come a long way since the early days, and the medical community has learnt a lot quickly. Now living with HIV means a life expectancy similar to someone not living with HIV. And that means we get some of the same issues as we age.
Often people only need to take 1 tablet a day to manage their HIV, and it can be simpler than managing high blood pressure.
Dr Daniel Chanisheff has been certified as an S100 HIV prescriber and can manage and prescribe HIV medication, as well as look after all your general healthcare needs.
We suggest visiting us every 3-4 months to make sure everything is going well and do a sexual health check at the same time.
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