HIV services

HIV stands for human immunodeficiency virus. Infection with HIV damages the body’s immune system, which makes it more difficult to fight off infections and some cancers.

HIV is a serious infection; more than 70 million people have been infected with HIV and about 35 million have died from HIV worldwide. Now effective treatment has been developed and people with HIV infection who take treatment daily can lead a full and long life.

Recent evidence shows that people who begin HIV treatment early in their infection have better health outcomes than those who begin HIV treatment at a later stage.

In Australia, people at the highest risk of getting HIV infection are:

• men who have sex with men
• people who have sex with people from countries with a high rate of HIV infection
• people who inject drugs
• people who had tattoos or other piercings overseas using unsterile equipment
• people who have sex with a person with a high risk of HIV as listed here.

People can be infected with several different sexually transmitted infections at the same time. Having a sexually transmissible infection (STI) makes it easier to also pick up HIV infection. And if someone is HIV positive, having another STI makes them more likely to pass on HIV to sexual partners.

HIV testing is recommended at least once every year for all gay and homosexually active men, and people who inject drugs. Testing within these groups should be done up to every three months if the person has many sexual partners (more than 5 within 3 months) or has anal sex without a condom. HIV testing is also recommended for:

• people with multiple partners or a recent partner change
• anyone diagnosed with a STI
• people using pre-exposure prophylaxis to prevent HIV
• sexual contacts of someone with HIV or at risk of HIV
• migrants from countries with a high rate of HIV
• pregnant women
• anyone with symptoms of HIV or an AIDS illness.

HIV infection can be prevented by:

• using condoms every time for anal and vaginal sex
• never sharing needles, syringes or other injecting equipment
• avoiding getting tattooed or having a body piercing done unless you are sure that sterile equipment is being used
• taking pre-exposure prophylaxis (PrEP)
  PrEP is an HIV prevention option for people who don’t have HIV but who are at high risk of becoming infected with HIV. Recent studies have shown that if a HIV negative person takes PrEP their risk of getting HIV from having sex with a HIV positive person is greatly reduced. PrEP contains two antiretroviral medicines that are also used to treat people who already have HIV infection. Condoms should be used in even if PrEP is being taken.
• a person with HIV infection taking antiretroviral treatment
  Antiretroviral medication taken by a HIV positive woman during pregnancy, childbirth and breast-feeding is used to help prevent spread of HIV from a woman to her baby. Antiretroviral treatment, if taken properly so that the level of virus in the blood of the person with HIV is very low, prevents the spread of HIV to sexual partners.

Anyone who is at risk of HIV infection should make sure that they are tested for HIV, so that they can be certain that they don’t place other people at risk of getting infected with HIV.

Treatment should be started as early as possible as this has been shown to result in better health outcomes and dramatically reduces the risk of passing on HIV.

WHAT is PEP?

PEP (Post-Exposure Prophylaxis) is a month-long course of drugs to help prevent HIV infection that is taken after a possible exposure to HIV.

The sooner someone starts PEP the better. It is most effective when started within 24 hours, but it must be started within 72 hours after a possible exposure to HIV.

The PEP drugs are the same drugs that HIV-positive people use to reduce its impact on their body.

PEP is short for Post-Exposure Prophylaxis.

Post = after
Exposure = a situation where HIV enters someone’s body (e.g., during sex without a condom or by sharing needles or injecting equipment)
Prophylaxis = prevention of disease

PEP isn’t guaranteed to work but does in the majority of cases.

PEP vs PREP

PEP: PEP stands for Post-Exposure Prophylaxis and is the focus of this website. It is a month-long course of drugs to help prevent HIV infection that is taken after a possible exposure to HIV.

PrEP: PrEP stands for Pre-Exposure ProphylaxisIt is a drug taken daily over a sustained period to help prevent HIV infection before exposure.

More information about PrEP can be found here.

What are the most common reasons for needing PEP?

• Sex without a condom with a person who has, or might have, HIV.
• Condom breaking or slipping off during sex.
• Sharing needles or syringes with a person who has, or might have, HIV.

How soon should I get PEP?

The sooner PEP is started after exposure to HIV the better. It is most effective when started within 24 hours, but it needs to be started within 72 hours. The longer you wait, the greater the chance that PEP won’t work. PEP usually isn’t given more than 72 hours (3 days) after exposure as studies show it is unlikely to be effective.

However, if you are unable to access PEP within the 72 hours, even if it has been up to 5-7 days since the exposure occurred, it is still worth seeking medical advice to see what your options are. This may include commencing a 3-drug combination of antiretroviral medications as soon as possible just in case you have become HIV positive. In this case, you would be starting very early treatment and minimising the damage to your immune system.

Where can I get PEP?

PEP is available from this sexual health clinic, Emergency Departments of most public hospitals, and some other clinics and doctors that specialise in gay men’s health and HIV.  If the exposure happens after hours, Emergency Departments are often the best place to go to make sure you start PEP as soon as possible.

HIV is diagnosed by a blood test. One type of test detects antibodies to the virus, while another type looks for the virus itself. It currently takes between 15-24 days before blood will show a positive test result after a new HIV infection (the window period), and may take longer. This means that if after a recent exposure more than one blood test may be needed over time to rule out a new infection.

Treatment with antiretroviral drugs is very effective at preventing damage to the immune system caused by HIV. People living with HIV on antiretroviral therapy can lead full, long and normal lives. There are health benefits for immediate HIV treatment initiation for people with HIV. Successful treatment greatly reduces the amount of virus in the person’s blood and other bodily fluids which prevents spread of the virus to other people.