The New Zealand AIDS Foundation says New Zealanders who resort to using imported generic PrEP need to be very careful about their use. The NZAF's advice comes as Australian group PrEPaccessNOW (PAN) advises that New Zealanders now have access to their PrEP assistance scheme, helping people to find doctors who are willing to prescribe the medication. PrE, or Pre-Exposure Prophylaxis, is a treatment whereby people without HIV take an HIV medication tablet, commonly Truvada, in advance of having unprotected sex to increase their chances of not contracting HIV. However, it has downsides such as expense, ensuring it is taken reliably and there can be unpleasant side-effects. “PrEP definitely should be available in NZ as part of the package of actions that can end HIV infections,” says Shaun Robinson of the NZAF. “For HIV-negative gay and bisexual men who don't use condoms PrEP is the next best method to protect their sexual health. “NZAF can understand people’s eagerness to get PrEP and their frustration that it's not available yet. Many countries are still grappling with how to make it available and we know that gay and bisexual men in these places are resorting to importing generic PrEP themselves as an interim solution,” he says. “In New Zealand parallel importing generic medications is legal; however, people need to be very careful that they are using PrEP in ways that are safe for them and the community.” “The critical factor is having a doctor who can provide good support to use PrEP. PrEP cannot be imported without a prescription and any doctor is going to have to feel confident that they can provide adequate support before they prescribe, because Truvada has not been through the Medsafe process for PrEP use. Only Gilead, the drug manufacturer, can initiate this process. This means the doctor has to take full responsibility for any problems that arise from the use of the medication.” Robinson says it is essential that people are tested for HIV before starting PrEP. “If someone uses PrEP when they already have the HIV virus, or if they use it inconsistently and contract HIV, there is a risk of the virus developing resistance to Emtricitabine, one of the antivirals in Truvada,” he says. “They will also need to keep regularly testing for HIV and other STIs (which PrEP does not protect against) and for changes in kidney function resulting from use of the drug. The Australasian Society for HIV Medicine (ASHM) has resources and guidelines for doctors on their website.” Robinson reminds people that PrEP will be available soon through the demonstration project that Auckland Sexual Health Service is working on with NZAF and other community groups. Anyone interested in being part of the project should visit the NZAF website for more information. “The ideal situation is that PrEP is available for anyone who needs it, regardless of their ability to pay, and that doctors in New Zealand are supported to provide the right care to people who use it,” he says. “That is what NZAF is working towards as one strand of the range of actions that can end HIV infections, which also includes increased testing, immediate access to treatment and continued high rates of condom use.”
Credit: GayNZ.com Daily News staff
First published: Tuesday, 1st March 2016 - 8:24am