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Massive PrEP increase in Australia, role of women’s use unclear

Australia has seen a huge increase in use of the HIV prevention drug PrEP, with most users being men in urban areas, new data shows.

The research, presented at the virtual 23rd International AIDS Conference by Dr Nicholas Medland of the Kirby Institute, shows that New South Wales has the highest rate of PrEP use in Australia, followed by Victoria and Queensland.

Only 1.5% of people taking PrEP during the study period were women, and the data did not show whether users were cis or trans.

Women were more likely to have reduced coverage, discontinuing the medication or taking it inconsistently.

Dr Medland suggested that this may be due to use of the medication as recommended, such as temporary use while a partner begins antiretroviral therapy, but could also reflect a failure to identify the role of PrEP for women.

Overall, Australia has seen a “rapid and sustained” increase in use of the medication, which has been linked to a dramatic drop in new cases of HIV.

As well as women, groups more likely to have lower PrEP coverage include younger men, those receiving government benefits, and those seeing doctors outside of the inner city.

Internationally, research by Dr Jonathan Volk and colleagues found that PrEP users in San Francisco were more likely to discontinue treatment if they were Black.

“Efforts are needed to reduce racial inequities and support persistence during periods of HIV risk,” the researchers said.

PrEP has been thoroughly proven as an effective prevention method for HIV, with the latest research finding no new cases with consistent use of the medication.

Increased testing and treatment, as well as PrEP, have been credited with “extraordinary” improvements in HIV prevention in Australia.

In Queensland, only 153 new cases of HIV were reported last year, in an achievement hailed as a “modern miracle”.

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