What if my doctor doesn’t know about PrEP?

 
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The good news is that any doctor in Australia can prescribe PrEP!

PrEP was approved for use in Australia by the Therapeutic Goods Administration (TGA) in May 2016 [1]

This made it possible for all doctors to prescribe PrEP to their patients at an affordable price.

In April 2017 PrEP was listed on the Pharmaceutical Benefits Scheme (PBS) making it affordable for anyone with a Medicare card. Since then, any doctor who is a general practitioner (and some nurse practitioners) have been able to prescribe PrEP to their patients. HIV specialist doctors can prescribe PrEP to HIV-negative patients however it is not the sole responsibility of HIV and sexual health specialists to prescribe PrEP. Any doctor can do it with minimal effort.

If your doctor tells you they are unable to prescribe PrEP because they do not have the right training, or do not know about PrEP you can explain to them that there is no specialist training required to prescribe PrEP. You can provide them with this letter – either take it on your phone or print it out to bring it along to your appointment.

Your doctor may wish to read more about PrEP and confirm which tests they need to run, and confer with the Australian PrEP prescribing guidelines before starting you on PrEP. That’s ok, they just want to make sure they are doing the right thing by their patient – you.

The best place to send your doctor for information about prescribing PrEP is the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine HIV (ASHM)

 

The ASHM website contains the current best practice guidelines for how doctors should prescribe both PrEP and PEP

ASHM has an online training module PrEP in Practice: Guidance for GPs which, while not required, can help your doctor navigate the PrEP prescribing process.

 

What if your doctor still will not prescribe PrEP to you?

All doctors have a responsibility to care for their patients. The number one rule they live and work by is ‘First, do no harm.’

Your doctor may be unaware eof how safe, reliable, and easy PrEP is – and may not wish to prescribe you PrEP if they are unfamiliar with it believing that PrEP may do you harm. We know this is not the case. In not prescribing you PrEP to a patient who is at risk of HIV your doctor may be leaving you at increased risk, and there for doing you harm by leaving you susceptible to acquiring HIV.  

Still no luck?

If your doctor is unwilling to do this – we would recommend speaking to the Practice Manager. The Practice Manager overseas the day to day running of the clinic, and handles any client complaints or issues. Speak to the doctor or with the reception staff at your clinic about raising your concerns with the Practice Manager.

If you are still unable to access PrEP after speaking with the practice manager, you have some options. You can make a complaint to your state or territory Health Complaints Commissioner, just take a look at the Commissioner relevant to your area. This would be the final step which you should undertake only if you have not followed the earlier steps.

What other options do I have?

If it is easier for you, you may want to visit another clinic. You can find a list of PrEP doctors on the pan website by heading to pan.org.au/doctors

However, if you wish to remain with your current GP clinic, and your doctor is still unable or unwilling to prescribe PrEP to you, ask them to refer you to one of their colleagues within the practice or clinic.

If I need some help?

If you need someone to advocate on your behalf, please contact us at any time and we will be happy to chat with your doctor or clinic about the benefits of PrEP. We can also link them in with the information we have mentioned, and send them some printed materials, and studies which have investigated just how safe and effective we know PrEP is.

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Got feedback? Got a question that we haven’t covered? We’d love to hear it!

Just e-mail info@pan.org.au with your question or comment, and please include the question title you’re writing about and be as detailed and specific as you can with your comments.

If possible, please provide links to any relevant sources. 
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Notes:

[1] PrEP drug gets TGA approval (Australian Doctor) https://www.australiandoctor.com.au/news/prep-drug-gets-tga-approval

[2] HIV PrEP available on PBS in Australia from 1 April (ASHM) https://www.ashm.org.au/news/hiv-PrEP-available-announced-on-pbs/

[3] Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine HIV pre-exposure prophylaxis: clinical guidelines. Update April 2018 (ASHM) http://viruseradication.com/journal-details/Australasian_Society_for_HIV,_Viral_Hepatitis_and_Sexual_Health_Medicine_HIV_pre-exposure_prophylaxis:_clinical_guidelines._Update_April_2018/  

[4] Prescribing PrEP in Australia training module (ASHM) https://lms.ashm.org.au/enrol/index.php?id=1129

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