HIV Prevention With PrEP In Melbourne

Hi my name is Dr George Forgan-Smith and I am a HIV PrEP prescriber based in Melbourne Australia. 

Dr George Talks about the side effects of PrEP also known as Truvada for HIV prevention.

Thank you for your interest in the PrEP a medication that can help prevent HIV infection. 

PrEP is a combination of 2 medicines used in HIV treatment taken as a single daily tablet. PrEP works by blocking HIV's ability to replicate, stopping it from taking hold in the body.

When taken as prescribed PrEP has been shown to be highly effective in stopping HIV transmission

PrEP For HIV Prevention In Melbourne

Before You Start PrEP

People who may benefit from PrEP includes people who may have HIV positive partners with detectable viral load, people who have found condom use to be inconsistent, people with recent diagnosis of some sexual infections as well as people who use substances such as meth amphetamines that can put people at higher risk of HIV infection.

Your doctor will help evaluate your risk of potential HIV infection and whether PrEP might be suitable for you.

PrEP is not for everyone, PrEP is a prevention tool. If during the inital testing for PrEP you are already living with HIV you should discuss benefit from considering treatment and your doctor can help you with this process. 

People who have existing kidney disease need careful monitoring and it's recommended talking with a HIV specialist before starting PrEP.

In my clinical experience I have only had one or two patients who's medical issues prevented them from being able to access PrEP.

How Does PrEP Work?

What Are The Side Effects Of PrEP?

A small percentage of people get GI side effects, constiation, diarrhea, gas or bloating. This usually resolves in a couple of weeks. I’ve found use of acidophilus yoghurt can help reduce the symptoms.

Rarely PrEP can affect kidney health, while rare we check kidney function each visit. Your doctor will check if you are on any other medications that can affect kidney function. These include some  diabetes medications and some medicines for pain or inflammation. Be sure to let your doctor know all your medicines you take, even one over the counter or only taken every now and then.

There is a rare association with reduced bone density, if you or your family have history of osteoporosis or medicines that can affect bone density we may wish to check your bone density before starting.

Before staring  PrEP your doctor will discuss your needs and your own particular risks for HIV. This is a chance to discuss side effects, how to take your medication as well as starting and stopping PrEP. 

Have You Heard Of PrEP For HIV Prevention

As part of starting PrEP your doctor will organise  a full sexual health screening as well as a check of kidney health. 

If you have had a high risk of exposure to HIV 72h previous to seeing your doctor they may wish to start a different medication to help prevent infection called PEP.

If you've had a high risk exposure longer than 72 previous but within a month of starting PrEP your doctor may need to carefully monitor your HIV status to ensure you continue to be HIV negative.

Testing Before Starting Truvada To Prevent HIV

How To Take PrEP

In Australia our recommendations is a single daily tablet of truvada.

When taken every day this has been shown to reduce the risk of HIV infection by about 99%

We understand that people occasionally miss a tablet, this does not greatly reduce it's efficacy, even when only 4 -6 tablets are taken each week it's still 96% effective.

If you are taking less than 4 tablets a week however there is not enough drug in the body to be considered protective.

It's helpful to find a daily routine to help remind you to take your tablet, for example if you have a coffee each morning, place the medication next to the coffee to remind you to take it.

It can be useful to have a spare tablet in a small container in your bag or jacket just in case you forget to take your tablet.

If you are struggling to remember to take your PrEP there are apps for your phone that can be a helpful reminder.

What Happens If You Miss A Tablet

When you start PrEP you need to have taken at least 7 days of medication before it has high levels of protection.

If you have had a change in circumstance and your risk of HIV infection is no longer high it is recommended you continue to take PrEP for 28 days after your last potential exposure to HIV before stopping the medicine.

As part of being on PrEP it's important to have check up with your doctor every three months. 

At each appointment you will have a full sexual health screening as well as a check of your kidney function.

This will include throat swab, rectal swab and urine test for chlamydia and gonorrhoea and a blood test for HIV, Syphilis, Hepatitis C as well as a check of the kidney functions.

You'll also be given another prescription for the next 3 months of medications. 

This is also a great chance to check in on how you have found the medication, any side effects and to answer any questions you may have.

Importing Generic Truvada Into Australia

How To Bring Generic PrEP Into Australia

What To Expect In Your 3 Monthly Appointments

What To Expect In Your 3 Monthly PrEP Appointment

Of course if you have any symptoms of sexual infections such as pain with urination, discharge, ulcers, sores, rashes or even pain in the throat or anus it's important to come in and get checked out. It's always best to get checked and treated if required sooner rather than later.

While you may occasionally be asked to share your medications with people interested in PrEP it's important they have the same comprehensive care you have so be sure to refer your friends to a local PrEP doctor so they can learn more if PrEP is right for them.

It’s important to note that PrEP only protects against HIV. Others STI's such as chlaymyda, gonorrhoea, herpes and syphils can still be transmitted. We know that use of condoms can help reduce their transmission so we still recommend considering use of condoms with your sexual partners. 

As previously mentioned you'll be getting a regular STI screening as part of your 3 monthly visit so even if you have an infection you'll be able to get treatment.

PrEP Doctor Melbourne

As previously mentioned you'll be getting a regular STI screening as part of your 3 monthly visit so even if you have an infection you'll be able to get treatment.

Of course if you have any questions about PrEP be sure to feel free to have an open and frank conversation with your doctor. 

We are here to help ensure you are getting the best care tailored for you and want to make sure you are 100% comfortable with your decision.  Be sure to note down any questions you may have and be sure to bring them up with your doctor.

Thank you for your time and again if you have any questions please feel free to contact myself or any of the PrEP doctors in your local area.

Poster Promoting PrEP For HIV Prevention, Photo by Dr George Forgan-Smith a PrEP Doctor In Melbourne Australia, webmaster of Is PrEP For Me http://isprepforme.comGeneric PrEP Medications Used For HIV Prevention. These medications are the same as Truvada manufactured under license and is equally as effective as the original drug in preventing HIV infections.

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