Archive | Prescribing PrEP

Use Of Condoms While On PrEP

One of the more common questions for people who are going on to PrEP is, does this mean that I can stop using condoms? We know that condoms have a role in all sexual health, not just HIV prevention. Taking PrEP every day does greatly reduce the risk of HIV infection. Adding condoms into the […]

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Renal Side Effects Of PrEP

PrEP does have some rare side effects that are very important to follow through with. The first one is that in some people, PrEP can reduce the function of the kidney. For this reason it’s very, very important that when you’re starting PrEP, that you have a very careful examination of the patient’s medical history. […]

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Contraindications To Starting PrEP

What are the contraindications of going onto PrEP? The number contraindication to go onto PrEP is that the person is already infected with HIV. For this reason, it’s very important at the beginning of the screening process that we do a test for HIV. We’re looking for HIV-1 antibodies, HIV-2 antibodies, and if we can […]

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Medication Review Before Starting PrEP

It’s important to have a review of people’s medications before they start PrEP. Any medicines that could affect renal function are worthwhile making sure that everything is okay. Examples include people who are on ACE-inhibitors, people who are on metformin, or who regularly use [inaudible 00:00:20], all of these drugs can affect kidney function so […]

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High Risk Exposures Before Starting PrEP

If you have a patient who there may be a risk that they have been exposed to HIV one month before initiating PrEP, I like to organise a second appointment to confirm HIV status before the person starts taking the medications. My normal flow would be that I organise the full screening tests, and if […]

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PrEP Prescreening Tests

The screening tests that I like to organise before starting PrEP include: I like to check kidney function. We need to know that the kidneys are working well and that they have an estimated glomerular filtration rate of more than 60. This is also a good opportunity to review a full sexual health screening. This […]

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What If A Patient Misses A PrEP Tablet

If a person misses an occasional tablet of PrEP, it’s not a huge impact on the efficacy of the drug. The most important thing is that we want to reinforce that people take the tablet every day. An occasional missed tablet is not going to greatly reduce the protection against HIV. The protection against HIV […]

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Who Is A Good Candidate For PrEP?

Anybody who at medium to high risk of HIV infection is a good candidate for PrEP. This can include people who are in a serodiscordant relationship, i.e., the person considering going on PrEP is HIV-negative and their partner is HIV-positive. Other people include men who have sex with men, who inconsistently use condoms; people who […]

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Choices For Generic Truvada

Sometimes people are confused with the generic versions of Truvada. The three main generics that I do recommend is Tenvir-EM, Ricovir-EM, or Adco Emtevir. These three are the main options that are provided under licence from Gilead and these are manufactured in a number of sites across the world. However, to help ensure compliance and […]

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General Flow For PrEP Follow Up Appointments

https://www.youtube.com/watch?v=Vg59jFubWOU The general flow for my follow-up appointments is that I have a conversation with my patients about any side effects, any issues that they’ve had with taking the PrEP. I do ask about missed tablets because a good opportunity to help reinforce ways that they can be more compliant with taking their medicines. It’s […]

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Legal Aspect Of Importing PrEP Into Australia

What is the legal status of importing PrEP in Australia? It is perfectly legal to import generic Truvada into Australia. However, there’s some things that we can do to help ensure that our patients are compliant with the law. The first thing is that we have to provide the prescription for the patient to be […]

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Reduced Bone Density On PrEP

In some people there have been concerns about bone density and the risk of fracture when taking PrEP. This is actually an extremely rare side effect. What we can say is if you have patients with pre-existing bone density issues or they are at high risk of osteopetrosis, it is worthwhile to consider a bone […]

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Guide For How To Take PrEP

How do you guide people on how to take PrEP? Currently the recommendations in Australia are that PrEP is taken every day. What I’d like to talk to my patients about is to find something that they do on a regular basis and tie taking the medicine to that. Say, for example, if they take […]

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Testing Positive In PrEP Pre-screening

If you discover that a person is HIV positive during the screening process of starting PrEP, the most important thing is do not start PrEP. PrEP is not appropriate for this person, this person needs to be on HIV treatment which involves three agents that are active against HIV. Truvada or PrEP only has two […]

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Explaining How To Import PrEP

When I talk to patients about how to import the drug, I personally take them to the PrEP Access Now website, http://pan.org.au. I walk them through the process. Key points that I want to remind them about is that they should never import more than 90 tablets at a time. I also want to reinforce […]

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Common PrEP Side Effects

What are the common side effects of PrEP? PrEP is actually quite a robust medication and it doesn’t have a huge amount of side effects. Probably the most common side effect is on initiation it can cause some abdominal side effects. This includes for some people constipation, for some people loosening of the stool, and […]

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Routine STI Screening

Some people can be at risk of sexually transmitted infections as is everybody who is sexually active. Every three months it’s a perfect opportunity to do a full sexual health screening and this includes a throat swab for chlamydia and gonorrhoea, a rectal swab for chlamydia and gonorrhoea, a urine test for chlamydia and gonorrhoea, […]

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PrEP & Hepatitis B

If a person is living with hepatitis B, PrEP can lead to an increase in hepatitis B viral load when the medicine is ceased. For this reason, if you have a patient who has been infected with hepatitis B, it’s worthwhile talking to a HIV specialist or PrEP specialist before initiating PrEP. Please follow and […]

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Increasing PrEP Complaince

After discussion on any particular issues with the tablet, I like to make sure that the person is having any problems in being able to take it every day. This is a really good opportunity to be able to talk about different strategies to improve the ability for a person to take the tablet daily, […]

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Urinary Tract STI Screening

In an asymptomatic person, a urine test for chlamydia, gonorrhoea, PCR, is best done. They say to have at least two hours since the last episode of urination. We want to get the first part of urine that comes out of the body. If a person has a pustular discharge, it is worthwhile to also […]

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How Does PrEP Work?

How does PrEP work? PrEP is a combination of two drugs: Tenofivir and Emtricitabine. The way it works is it stops HIV’s ability to create the second strand of RNA that is later used to enable replication within the T cells. When taken every day, Truvada, the combination of the two drugs, actually stops HIV […]

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PrEP Only Protects Against HIV

PrEP is only effective against HIV. It does not affect any other sexually transmitted infections. For this reason, it’s really important that you reinforce the idea of regular sexual health screening, as well as the use of condoms and their ability to help reduce the transmission of STIs as well. Please follow and like us:

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What Is PrEP?

What is PrEP? PrEP is a medical intervention that helps reduce the risk of HIV infection in people who are at risk of HIV infection. It’s a tablet, and when taken every day, it can reduce the risk of HIV by up to 99%. Please follow and like us:

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PrEP For Doctors

Welcome to “Is PrEP For Me”: The Doctors’ Edition. In this video series, I want to share as much information as I can about PrEP. Not only about what PrEP is and how it works, but also who it’s for, how to prescribe it and how to continue prescribing it. As a caveat, I just […]

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