The Turnbull government is set to approve a revolutionary new drug that has been touted as the beginning of the end of HIV in Australia.
On Friday, the Pharmaceutical Benefits Advisory Committee will issue a “positive recommendation” for the drug Truvada, more commonly known as PrEP “pre-exposure prophylaxis” – an antiviral medication shown to be “99 per cent” effective in preventing HIV infection.
If approved by Health Minister Greg Hunt and listed on the Pharmaceutical Benefits Scheme (PBS), the cost of PrEP would fall from $10,000 a year to about $40 a month for people at “high risk” of HIV infection.
The Australian Federation of AIDS Organisations (AFAO) estimates the drug would be available to 31,000 gay and bisexual men and would not only reduce the rate of HIV transmission in Australia by up to half, but also allay many men’s fears about having sex.
AFAO chief executive Darryl O’Donnell told The New Daily the approval of PrEP would be an “absolute game-changer” for HIV in Australia.
“The research tells us that that a 50 per cent reduction in HIV is possible [with the wider availability of PrEP],” he said.
Mr O’Donnell linked the drug to a 25 per cent drop in total HIV notifications in the first half of 2017 in New South Wales, where the University of NSW has been conducting a trial involving 8000 men since early 2016.
“In NSW we have seen the greatest drop in [HIV] infections since the epidemic began [in the early 1990s],” Mr O’Donnell said.
“We are now seeing quite powerful evidence of just how effective this intervention is, which is indicative of what will happen in other states and territories [where trials are also under way].”
Mr Hunt did not respond to The New Daily’s requests for comment.
While Australia’s incidence of HIV transmission is low by international standards, it was still “stubbornly flat” around 1000 new infections each year, Mr O’Donnell said.
To date, users have been able to access the drug only via the state and territory-based trials or from online pharmacies for between $5000 and $10,000 a year.
But if PrEP is adopted into the PBS, it would become available on a three-monthly prescription basis to HIV-negative patients deemed to be at high risk of infection.
One of the conditions of the prescription would be to undergo tests for HIV and sexually transmitted diseases.
A 2014 New York Times article questioned the claims that PrEP was 99 per cent effective in preventing transmission, but Mr O’Donnell said the body of large-scale research had since grown to make the figure “absolutely accepted” and that PrEP was “without doubt, astonishingly effective”.
But while PrEP is “critically important”, it was not the solution and only one part of many elements required to achieve the ultimate goal of eliminating HIV by 2020, Mr O’Donnell said.
“Many men will stick to just using condoms,” he said.
“But if you want to make sure [of not contracting HIV], or for a person who struggles with the use of condoms, there are now additional options for them, and PrEP is an extraordinarily effective option.
“We would hope it would make a significant dent in notifications in Australia … but to eliminate HIV transmissions will take a lot more work.”