Steven Spencer, 27, told The Sydney Morning Herald he used PrEP “on demand,” a phrase referring to taking the medication before and after sexual encounters on the advice of doctors.
The following is a statement from ACON CEO Nicolas Parkhill on reports of a NSW HIV seroconversion case involving PrEP use:
“ACON is heartened to hear that Steve has been supported by friends and community since his diagnosis. We understand that since his diagnosis, Steve has been able to access immediate treatment and has already achieved an undetectable viral load – which is good news.
“We know that for any person diagnosed with HIV, early treatment of HIV ensures the best long term health outcomes. Further, studies show that a person living with HIV who achieves a sustained undetectable viral load cannot transmit HIV, even if a condom is not used during sex.
“ACON has been engaged in a number of PrEP promotional initiatives through Ending HIV and more recently the Expanded PrEP in Communities (EPIC-NSW) PrEP implementation trial, which saw almost 10,000 people, the majority of whom were gay men, commence taking daily PrEP.
“There is no doubt that PrEP is highly effective at preventing HIV. With an estimated 450,000 people taking PrEP globally, there have only been a handful of cases where HIV seroconversion has occurred while the person has been taking PrEP. The overwhelming majority of PrEP users in Australia and around the world continue to be protected by this powerful HIV prevention tool.
“We are aware that there are some people in NSW who have considered alternative dosing regimens, such as on-demand PrEP. This is a dosing strategy involving taking PrEP pills according to a carefully timed schedule before and after sex. This dosing regimen has demonstrated high levels effectiveness through clinical studies overseas, and is reflected by the Australian clinical guidelines for prescribing PrEP*. However, should you wish to consider taking PrEP on-demand rather than daily, you should fully explore the choice between daily PrEP dosing and on-demand PrEP with your doctor, to ensure you understand the dosing and adherence requirements.
“Discussion amongst community, whether online or otherwise, that centres around speculation regarding how HIV is acquired remains unhelpful, and only furthers the harm and stigma faced by people living with HIV.
“This case does not change the strong evidence that PrEP is a highly effective HIV prevention strategy. Alongside regular HIV testing and other HIV prevention strategies, such as condom usage, maintaining an undetectable viral load or Post Exposure Prophylaxis (PEP) in an emergency – we know we can dramatically reduce new HIV transmissions.
“ACON runs a range of services that support people living with HIV including our Genesis workshops for men who have been recently diagnosed. We also provide support to gay and bisexual men who are wanting to explore different HIV prevention strategies, like PrEP. For more information on our support services, visit acon.org.au/hivsupport and for HIV prevention, visit endinghiv.org.au/stay-safe.”
*A copy of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine HIV pre-exposure prophylaxis: clinical guidelines, can be found here: http://viruseradication.com/journal-details/Australasian_Society_for_HIV,_Viral_Hepatitis_and_Sexual_Health_Medicine_HIV_pre-exposure_prophylaxis:_clinical_guidelines._Update_April_2018/
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