A second case of an Australian testing positive for HIV while using pre-exposure prophylaxis (PrEP) has emerged this week.

The preventative treatment has proved to be approximately 99% effective, and is most often prescribed as a once-a-day pill. In this instance, 27-year-old Steve Spencer was following an ‘on-demand’ regime, which is sometimes referred to those who don’t have sex regularly.

Since his diagnosis, Spencer has begun treatment and his viral load is now undetectable after six weeks. Undetectable viral loads can not be transmitted by sexual intercourse.

“I can acknowledge why people would be fearful of this or have concerns for themselves or their loved ones,” Spencer told the ABC, “I’m maybe a little unlucky, but that’s how the cookie crumbles and I am not angry at all, I don’t hold a grudge.”

“Even though my case may sow a seed of doubt, I don’t think it should at all… I chose to come out this way to reduce the stigma attached to HIV – to show people that I am proud of who I am.”

Associate Professor Edwina Wright of the Australian Society for Sexual Health Medicines says the ‘on-demand’ method prescribes two pills before sexual activity, with another two to be taken over the next 48 hour period.

“There’s one excellent trial which shows reduced HIV transmission by 86 per cent,” Wright said.

“We’re still waiting on further studies to see whether it’s just as effective as taking it daily.”

Matthew Bacon, Men’s Sexual Health Officer at the WA AIDS Council, released a statement today emphasising the effectiveness of PrEP as a preventative tool.

“PrEP is currently being utilised around the globe by between 455,000 and 460,000 people, and there have only been 7 situations where people who have been correctly using this medication have seroconverted,” Bacon said.

“Initial findings from the IPERGAY trial found that daily use of PrEP was a more effective method of preventing HIV, but that did not mitigate the on-demand dosing method as offering high efficacy at preventing HIV when condomless sex was occurring.

“These initial findings have resulted in further trials taking place in Europe (France, Belgium and Amsterdam) and interim data is suggesting on-demand dosing is effective and a legitimate method of prevention.

“Despite this new seroconversion while using on-demand PrEP it does not erase the thousands of people that are currently being protected from HIV through on-demand dosing, but until further information from trials is made available utilising a daily dosage method will prove most effective.”

“PrEP and U=U (Undetectable = Untransmissible) have already dramatically changed HIV statistics in Australia and paired with continued condom usage and the use of PEP in emergencies, HIV rates can and will continue to decrease significantly.”

OIP Staff