Australia is experiencing a shortage of an important HIV prevention medication and sexual health organisations are urging those who rely on it to plan ahead so they don’t run out.
Pre-exposure prophylaxis, or PrEP, is an antiretroviral drug taken by people at high risk of HIV infection, which if used every day has an efficacy of rate of 99% among gay and bisexual men. It became available on the PBS in 2018 and has been hailed a “game-changer” at preventing HIV transmission.
A spokesperson for the Therapeutic Goods Administration (TGA) confirmed shortages of multiple brands of tenofovir/emtricitabine combination tablets, used for PrEP to reduce the risk of sexually acquired human immunodeficiency virus (HIV-1).
The same tablets are also approved by the medicines regulator for the treatment of HIV-infected adults, in combination with other antiretroviral agents.
The spokesperson said suppliers of the drug have reported issues including manufacturing, commercial changes and viability. The TGA has recently approved the importation and supply of overseas-registered tablets to help ease the shortage.
Matthew Vaughan, the director of HIV and sexual health at Acon, said his organisation understands more supply of the medication is expected to arrive within the coming months.
“If you are currently taking PrEP, please do not leave restocking your medication to the last minute. Given the current situation, you may need to visit more than one pharmacy to find a supply, and there may be limitations on how many bottles of PrEP you are able to obtain from the pharmacy. Please plan ahead to ensure you don’t run out,” Vaughan said.
He advised anyone unable to obtain PrEP through pharmacies to access it online, with information available at PrEP Access Now.
Vaughan suggested anyone taking daily PrEP not engaging in regular or frequent sexual activity may want to consider an on-demand dosing schedule.
He said the “situation may be concerning, but we are confident that it will be resolved in the coming months”.
The shortage comes as the Kirby Institute released Australia’s latest data on HIV diagnoses on Wednesday.
While the 722 new HIV diagnoses reported nationally in 2023 was up from 553 in 2022, researchers said it was still a lower number of annual cases compared to pre-pandemic levels, and continued a long-term trend of declining diagnoses.
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Dr Skye McGregor from the Kirby Institute said “the increase in 2023, compared to Covid pandemic years, is likely associated with the resumption of pre-Covid sexual behaviours, testing and the movement of people in and out of the country”.
Overall, HIV diagnoses had reduced by 33% over the last decade, with a 64% reduction in diagnoses among Australian-born gay and bisexual men.
“These long-term reductions tell us our strategies to eliminate HIV transmission – such as testing, HIV pre-exposure prophylaxis (PrEP) and treatment – are working,” McGregor said.
The Kirby Institute’s Prof Andrew Grulich said although record numbers of people were prescribed PrEP in 2023 for HIV prevention, there are inconsistencies in HIV prevention coverage.
According to a 2024 report by the University of New South Wales’ Centre for Social Research in Health, while overall coverage is high, those under 25 years old, bisexual men and those living in suburban and regional areas are less likely to report PrEP use and more likely to report some risk of HIV transmission.
“We have the strategies and technologies to eliminate HIV transmission in Australia. But we need to make sure PrEP and other prevention strategies are reaching the populations that most need them,” Grulich said.
