Australia faces shortage of HIV prevention drug PrEP as experts warn users to plan ahead

Australia is facing a shortage of a key HIV prevention drug. Sexual health organisations are urging people who rely on the drug to plan ahead so they don’t run out.

Pre-exposure prophylaxis, or PrEP, is an antiretroviral medication taken by people at high risk of HIV infection. When taken daily, it has a 99% efficacy rate among gay and bisexual men. It was made available on PBS in 2018 and has been hailed as a “game-changer” in preventing HIV transmission.

A spokesperson for the Therapeutic Goods Administration (TGA) confirmed that there is a shortage of several brands of tenofovir/emtricitabine combination tablets, which are used for PrEP to reduce the risk of sexually transmitted human immunodeficiency virus (HIV-1).

The same tablets have also been approved by the medicines authority for the treatment of adults with HIV infection, in combination with other antiretroviral agents.

The spokesman said suppliers of the drug had reported issues including production, commercial changes and viability. The TGA recently approved the import and supply of overseas-registered tablets to help alleviate the shortage.

Matthew Vaughan, director of HIV and sexual health at Acon, said his organisation expects more drugs to arrive in the coming months.

“If you are currently taking PrEP, don’t wait until the last minute to get your medication refilled. Given the current situation, you may need to visit more than one pharmacy to stock up, and there may be restrictions on the number of bottles of PrEP you can get from your pharmacy. Plan ahead to make sure you don’t run out,” Vaughan said.

He advised anyone who couldn’t get PrEP through pharmacies to get it online, with information available at PrEP access now.

Vaughan suggested that anyone taking PrEP daily who does not have regular or frequent sexual activity should dosage schedule on request.

He said the “situation may be worrying, but we are confident that it will be resolved in the coming months”.

The shortage comes after the Kirby Institute published the latest Australian data on HIV diagnoses on Wednesday.

While the number of new HIV diagnoses reported nationwide in 2023 was 722, down from 553 in 2022, researchers said it was still a lower number of annual cases compared to pre-pandemic levels. What’s more, the long-term trend of declining diagnoses continued.

Dr Skye McGregor from the Kirby Institute said that “the increase in 2023, compared with the years of the Covid pandemic, is likely to be related to the resumption of pre-Covid sexual behaviour, testing and the movement of people in and out of the country”.

Overall, HIV diagnoses have declined by 33% over the past decade, with a 64% decline among Australian-born gay and bisexual men.

“These long-term reductions demonstrate that our strategies to eliminate HIV transmission – such as testing, HIV pre-exposure prophylaxis (PrEP) and treatment – ​​are working,” McGregor said.

According to Andrew Grulich of the Kirby Institute, while a record number of people will be prescribed PrEP for HIV prevention in 2023, there are inconsistencies in HIV prevention coverage.

According to a 2024 report According to the University of New South Wales Centre for Social Research in Health, while overall coverage is high, people under 25, bisexual men, and those living in suburbs and regions 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 ensure that PrEP and other prevention strategies reach the populations that need them most,” Grulich said.