In addition to encouraging safer sexual practices, health professionals can assist at-risk patients with the following HIV reduction strategies:
- Encourage frequent HIV testing for people at risk. Early diagnosis allows early access to treatment, which improves long term health outcomes and reduces the risk of HIV transmission to sexual partners.
- Facilitate access to HIV pre-exposure prophylaxis (PrEP) for people who may have ongoing exposures to HIV. PrEP is approved for use in Australia but is very expensive and not covered by a health care card. People who wish to start low or no cost PrEP can import this themselves (current cost about $50/month) or join a trial. Victoria’s trial (PrEPX project) has reached capacity, but there is a waiting list and more places may open up in the future.
For information on the PrEPX trial, see: https://www.alfredhealth.org.au/research/research-areas/infectious-diseases-research/prepx-study
Be aware of HIV post-exposure prophylaxis (PEP). This is important if a patient presents within 72h of a possible HIV exposure. To maximise its effectiveness, PEP must be started as soon as possible. PEP is available from large hospital emergency departments, the Melbourne Sexual Health Centre, and general practices that specialise in HIV and sexual health.
For information on where to access PEP: http://getpep.info or http://pan.org.au/
Or phone the PEP hotline:
1800 889 997
We can do many things to help a patient to minimise their HIV risk, but all these strategies are dependent on the identification of risk. Patients at risk of HIV include men who have sex with men (MSM), transgender people, women who have sex with MSM, and people who inject drugs. This highlights that routine medical history taking should include a sexual history and drug use history.
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