HIV Insta Post #1
Brushing up on HIV meds this weekend starting with PrEP...
PrEP or Pre-Exposure Prophylaxis is a medication that is used to prevent the transmission of HIV in people who are at medium to high risk of transmission of HIV. In Australia, it is available on the PBS thus costs ~$38 per month (~$7 if health care card holder). GPs can prescribe PrEP in Australia.
Ppl considered to be at high risk of HIV transmission:
* have an HIV positive partner with detectable viral load * have condomless anal intercourse * use methamphetamine * recent history of rectal chlamydia/ gonorrhoea
* recent history of syphilis
* intravenous drug use
Those who PrEP is NOT suitable for: * already HIV positive (should be on treatment) * significant kidney impairment
PrEP is most effective taken as a daily pill which prevents transmission by 99% (note not 100% but pretty good). It does not prevent the transmission of other infections so it is important to use condoms if you want to prevent other infections such as chlamydia, gonorrhoea & syphilis. While these other infections CAN be treated with antibiotics, increasingly there are multi-resistant strains of these diseases which are very difficult to treat/cure.
Side effects of PrEP include initial tummy upset such as bloating, diarrhoea or constipation, kidney damage and reduced bone strength.
Those taking PrEP need review with their GP/ prescriber every 3 months to check for sexually transmitted infections, HIV status & kidney function.
If you are wishing to stop PrEP you need to take for 28 days after your last exposure to HIV before it is safe to stop.
I am happy to prescribe PrEP to patients. I am also an authorised s100 HIV med prescriber.
HIV Insta Post #2
We now have very effective meds for the treatment of HIV & life expectancy for someone with HIV (on treatment) is almost the same as someone without HIV. However, until a cure is found, HIV meds have to be taken forever. It is important for everyone with HIV to be on treatment to prevent the development of AIDs & prevent HIV transmission. Those who get treatment & keep their viral load undetectable by taking their meds regularly have an almost 0% risk of sexually transmitting HIV.
There are several types of HIV meds & typically a total 3 different HIV drugs from at least 2 different classes are used. This suppresses infection while reducing the risk of resistance developing. Many of these combos are now avail. in a single daily pill. Aside: don’t the names of the drugs sound like elves or warlock names, e.g. Tenofovir, Dolutegravir & his cousin Raltegravir.
Treatment choice is individualised & takes into consideration things like other medical conditions or meds, type of HIV & lifestyle factors. As this is a complicated medical decision, I ask people to see an HIV specialist first but as an authorised s100 prescriber, I am able to provide ongoing monitoring & scripts as well as coordinate chronic disease care plans for optimising your health.
While taking HIV meds it is important to them daily to keep the virus suppressed & to reduce the risk of transmission & development of resistance. You should also make sure to check any meds/ vitamins as well as any recreational drugs for interactions that might affect the efficacy & toxicity of your HIV meds.
You can check for interactions at: hiv-druginteractions.org
Side effects of HIV meds *tummy upset (most common, normally settles) *impairment of kidney function *rashes *neuropsychological symptoms e.g. mood disorders & insomnia
Longer term effects from treatment &/or HIV can include: *kidney failure *bone disease *heart, neurological & liver disease *cancer
This emphasises the importance of a good GP in the ongoing preventative health care of anyone with HIV.
Treat early. As soon as someone is diagnosed with HIV, they should start treatment. By having a undetectable viral load this protects the adverse health impacts from HIV while also preventing transmission. Stay safe. Employ HIV prevention strategies including condoms, PrEP, undetectable viral load or a combination.
For more info: endinghiv.org.au