FDA Approves Descovy For PrEP HIV Prevention

New Drug For HIV Prevention Now Available: Descovy Pic: San Francisco AIDS Foundation

Great news that Descovy has now been officially approved by the US FDA as it’s 2nd form of HIV prevention medication: PrEP.
Press Release Here: https://www.fda.gov/news-events/press-announcements/fda-approves-second-drug-prevent-hiv-infection-part-ongoing-efforts-end-hiv-epidemic

Descovy has been shown effective in cis males as well as trans females. It has not been approved for cis females or trans males.

Descovy is not yet approved for PrEP in Australia.

Who Is A Candidate For Descovy?

Descovy is noted to have less side effects with regards to kidneys. While Truvada PrEP is excellent for many people, it was not recommended for people with reduced kidney function, in particular with a eGFR less than 60. GFR is an estimation of the filtration rate of kidneys.

Descovy is an option for people with reduced kidney filtration.

I’m On Truvada, Do I need to change?

If you are currently on Truvada for PrEP with no issues, there is no need to change medications.

Can You Get Descovy In Australia?

Descovy is only approved for the treatment of HIV in Australia.

It is available off label for PrEP meaning it can be bought in Australia, at significant cost, or purchased online as a generic. For either option you will require a prescription.

If you feel that this may be an option for you I recommend discussing with your PrEP doctor or local HIV prescribing doctor.

Regards Dr George Forgan-Smith

Difference Between Intermittent & Daily PrEP

Dr George talks about PrEP on demand vs daily PrEP


Key points between PrEP on demand and daily PrEP

Daily PrEP

  • Ideal for all people with no contraindications to PrEP (kidney impairment, bone issues or allergic reaction Tenofivir or Emtricitabine)
  • Tablet is taken daily
  • 7 days of tablets recommended before optimal protection
  • Offers 99% reduced risk of HIV transmission per act
  • If you wish to stop you need to take for an additional 7-28 days after your last potential exposure to HIV
  • Regular review with your PrEP provider every 3 months vital

PrEP On Demand

  • Only studied in men and trans women
  • May not be effective for women and trans men. Daily PrEP is the recommended treatment for these groups of people
  • Not suitable for people with active Hepatitis B infection
  • Dosage regime of 2 / 1 / 1
    • 2 tablets of PrEP 2-24 hours before anticipated sexual activity
    • If sex happens, 1 tablet of prep every 24h till 48h has passed since last sexual activity
  • Regular review every 3 months with your PrEP provider is vital

Full details, video and explaination here: How To Take Intermittent PrEP For HIV Prevention

“transcript”
Hey guys, it's Dr. George here. I just wanted to do a brief video to explain the differences between daily prEP and prEP on demand. Here in Australia, both are included as part of the Australian prEP guidelines and both are considered to be highly effective. There are some differences and I just wanted to highlight those. Daily prEP is taken every day. When it's taken every day, we know that it offers really good protection for all people taking it and that's a 99% reduction in risk of HIV infection. Now, there is prEP on demand, also called intermittent prEP. This is for people who either have really bad side effects to taking the tablet every day who may have issues with their kidneys or for people who really aren't having sex that often that would put them at risk of HIV infection. Importantly, we need to note that intermittent prEP is only for men or trans-women. If you own a cervix, if you're female or is you are a male trans-person, then intermittent prEP is not fully studied so we can't guarantee that it's going to be able to ... You have a high enough level of protection against HIV so intermittent prEP only for men, only for trans-women. How does it work? When you feel that you are going to be having sex in a way that could lead to an exposure to HIV, you need to take two tablets of prEP two to 24 hours before you have sex. If you do have sex, then you need to take one tablet of prEP every 24 hours until 48 hours has passed, free of sex. It's very straightforward. Now people are wondering, "What's the efficacy of this?" There has been a recent case in Australia and there were some concerns that is intermittent prEP as effective as daily prEP? As previously mentioned, if you are a trans-male, if you are a female, then absolutely you should be on daily prEP, you should not be using intermittent prEP. Now if we look at the studies, so the IPERGAY Study coming out of France has had two sequential arms, and the first arm showed that it was 87% effective at reducing the risk of HIV. That is, when taken as directed as I just previously described, it would reduce the risk of HIV quite significant, 86%. Now there was a second open study that continued as part of the IPERGAY Study and that number actually rose to 97%. We know that the strategy is effective, it works, and there's a 97% reduction in risk of HIV infection per episode. I suppose the thing is that you need to make a decision about what is going to be best for you but when it comes to daily versus intermittent, if you're having a moderate amount of sex then I would say go with daily. If you're only having sporadic risks of HIV infection, then it's probably best to consider intermittent prEP if you are worried about taking a tablet every day. Some people come to me and they say they're worried about going on holiday, like, they're off to a trip to, I don't know, somewhere and they're thinking, "Well, I would like to have prEP while I'm away." What I would recommend in those situations is you can do either, intermittent prEP or daily prEP. However, if you're going to do the daily prEP, you need to start the daily prEP seven days before you travel, then take the tablet every day during your travel. Then, depending on which study you look at, you need to take it for seven to 28 days after your last potential exposure to HIV. Current guidelines in Australia say 28 days. However, there are studies that say it could be between seven to 28, if you look at recent documents that have been published. Of course, talk with your doctor, this is the important thing. If you are worried or concerned, have a talk to an experienced prEP provider who can provide all of this information for you. I hope this has offered some clarity. I know it's a little bit longer than I expected and a little bit wordier than I expected but please, if you have any questions, come on in, ask away, send me a message and I'll do my best to get an answer for you. I hope this was helpful.

Why Does My PrEP Look Different?

Pan.org.au

Currently PrEP is available as a generic version of the drug Truvada.

Each manufacturer will create a pill which may look a little different however all of the generic forms of Truvada contain the same active ingredients Tenofivir and Emtricitabine, the medication that protects against HIV infection that makes PrEP work.

UK studies have shown the generic medications to be equal to the original Truvada brand.

If you are receiving your PrEP from your Australian pharmacy or via any of the following online pharmacies you can feel reassured that your PrEP is geunine and effective.

Of course if you have any questions about PrEP be sure to talk to an experienced PrEP doctor in your local area. If you are in Melbourne I am happy to chat.

Dr George Forgan-Smith
267 Collins St, Melbourne VIC 3000
(03) 9654 6088
https://goo.gl/maps/tHcArBiMH4p

Regards

Dr George Forgan-Smith

6 Tips To Help Ensure You Take Your PrEP Daily

PrEP is a tablet when taken daily can reduce the risk of HIV infection by over 99%. To be most effective the it is recommended to take the tablet on a regular basis ie. each day.

Life can be hectic and for some a daily tablet can be tricky. A study at the City University of New York School of Public Health has identified 6 different ways to help ensure you are remembering your daily tablet:

Using A Pill Box

Pill boxes are a great way to help give a visual reminder of whether you have taken your tablet or not.
They also have the advantage of letting you know when you are about to run out of your medications, a second reminder for when you need to return to your doctor for a new script as well as your quarterly sexual health check up.

Visual Cue Systems

There are many ways to remind yourself to take your tablet… Some ideas include a sticker on your mirror that reminds you that you need to take a tablet.
One idea that worked for a patient was a post it note on his coffee container that said “Have you taken your pill?” Often it’s the simple things that work the best!

Having A Regular Routine

The human mind loves routine… Get up, take your pill, have a shower. This has been my daily routine for years…
The key is to find something that you do on a regular basis and then attach taking your pill to this. Do you always start your day with a coffee? Stick your tablets next to your coffee cup so you will always be reminded of your PrEP when you prepare your coffee.
If you take your medicine before you sleep, put the tablets beside your bed with a glass of water to remind you. Find that one thing you do on a regular basis!

Set A Smart Phone Reminder

Almost all phones now have alarms and reminder systems you can set to go off on a daily basis.
One simple idea is to set an alarm that goes off each morning say 30 min after you have woken up. Call it “take your pill” and you have your daily reminder.
Of course there are many apps you can download onto your phone to remind you to take your tablets. Check them out but I find the simple solutions are the ones that work the best.

Carry A Spare Pill With You

Life can be hectic. Sometimes we leave the house quickly and can forget out tablets. I have a small metal pill container that has a couple of my PrEP tablets inside it. I’ve thrown this into my work bag so I have a spare if I ever need it. I found this on on Amazon that works great for me -> Waterproof Pill Container
TIP: make sure you get a water proof one just in cast it gets thrown into the washing machine.

Get A PrEP Buddy

If you have a close friend who also takes PrEP, set up a daily check in where you call or text to remind each other to take your medications…
This simple system can help ensure you both are taking your meds as well as a great chance to keep in touch!

As you can see there are many ways to ensure you are able to take your tablet each day. Remember that when taken daily PrEP is highly effective in reducing the risk of HIV infection. It’s normal to miss one or two tablets, I hope these ideas reduce this occurrence helping you stay healthy and in control of your health.

What’s your favourite way to ensure you get your daily pill? Leave a comment below.

Dr George

หยุดการติดเชื้อการติดเชื้อ เอชไอวี | PEP Thai

หยุดการติดเชื้อการติดเชื้อ เอชไอวี
หากคุณมีความเสี่ยงต่อการติดเชื้อเอชไอวีให้พบแพทย์ทันที
หากคุณมีความเสี่ยงต่อการติดเชื้อเอชไอวี PEP เป็นยาที่สามารถหยุดการติดเชื้อเอชไอวีได้
สิ่งที่สำคัญที่สุดคือการใช้ PEP ภายใน 72 ชั่วโมงหลังจากเสี่ยงต่อการติดื้อเช เอชไอวี
ดังนั้นการไปพบแพทย์จึงเป็นสิ่งสำคัญ
ถ้าเป็นวันหยุดสุดสัปดาห์ให้ไปที่ห้องฉุกเฉินของโรงพยาบาล
ตั้งแต่วันอังคารถึงวันศุกร์ดร. “GEORGE FORGAN-SMITH” สามารถช่วยคุณทดสอบและใช้ยาหากคุณมีความเสี่ยงต่อการติดเชื้อ
หากคุณต้องการพบฉันที่ Collins Street Medical Center เป็นสิ่งสำคัญที่จะบอกคนที่แผนกต้อนรับว่านี่คือการนัดหมาย PEP ด่วน เราสามารถทำการทดสอบทั้งหมดและเริ่มการรักษาเพื่อป้องกันเอชไอวี
คุณสามารถทำการนัดหมายทางโทรศัพท์ + 61 3 9654 6088

如果您已经接触过艾滋病毒,请获得紧急医疗帮助。| PEP Mandarin Chinese

如果您已经接触过艾滋病毒,请获得紧急医疗帮助.

如果您接觸過艾滋病病毒,PEP是一種可以阻止艾滋病毒感染的藥物。
最重要的是,PEP確實需要在接觸HIV後72小時內服用。
因此,快速去看醫生很重要。
如果是周末,請前往醫院的急診室。
從周二到週五,George Forgan-Smith博士可以幫助您接受檢測和藥物治療,如果您已經接觸過艾滋病毒。這些可以幫助預防感染。
如果你想在柯林斯街醫療中心看到我,重要的是告訴接待處的人們,這是一個緊急的PEP預約。我會確保你被人看見。我們可以做所有的測試並開始治療以預防艾滋病毒。
您可以通過電話預約 +61 3 9654 6088

Do I Still Need Regular PrEP screening now Truvada is on the PBS?

Just received the question about whether PrEP protocols are going to change now that PrEP medications are covered under the Australian PBS?

To answer the question, no. All people on PrEP will still need regular STI screening and health checks every 3 months.

It’s important to get a quarterly appointment with your doctor for a new script and the following recommended testing:

  • Throat & anal swabs as well as a urine test for Gonorrhoea & Chlamydia.
  • Blood tests for HIV, Syphilis, hepatitis C as well as a health check of your kidneys.

I hope this helps clear up any questions.

Dr George Forgan-Smith