PrEP: The blue pill being used to prevent HIV

Five perspectives on the drug awaiting approval in Australia

Australia recently set itself an ambitious goal: put a stop to new cases of HIV by 2020.

It will be a tough deadline to meet given the number of people living with the virus has been steadily increasing since 2000.

Now a major breakthrough in the fight against the epidemic is generating a lot of buzz in the gay community.

PrEP, short for pre-exposure prophylaxis, is a blue pill containing the same combination of medicines used by people already living with HIV.

International clinical trials have proven that when taken once a day, PrEP can reduce the risk of infection by up to 90 per cent.

PrEP, manufactured by Gilead and marketed as Truvada, is not yet approved for preventative use in Australia so many gay men are forced to come up with creative ways of obtaining the drug.

When I got my prescription, it was a hugely emotional moment. And what my doctor said to me was 'you're doing an amazing thing, you're contributing to the end of the epidemic' and that's the way that I view it.

More than three decades after the outbreak of HIV/AIDS in Australia, the risk of contracting the virus still lingers in the minds of many gay men.

"We've been raised for 30 years to be afraid of sex," Melbourne university student Steven Spencer told 7.30.

Condoms have long been the focus of sexual health awareness campaigns within the gay community but research from Sydney's Kirby Institute has shown rates of unprotected sex are on the rise.

Mr Spencer, 23, admits to occasionally having sex without a condom but says he feels much more relaxed about it since he began using PrEP.

"It just takes away so much of the stress and anxiety associated with the sex that we have," he said.

"It can pretty heated and passionate and you make all sorts of weird decisions during those moments, especially if it's fogged by alcohol or other drugs.

"Now we're not afraid of HIV anymore because we've got something to stop it."

It was a definite shift for me ... because when I was a young gay, like 20 or so, I was paranoid about sex. The safest way to do it was to Glad Wrap my entire body, as far as I could tell.

Mike Downes is taking part in an Australia-first trial of PrEP that launched in Victoria last June.

While the efficacy of the drug is already backed by strong evidence, researchers hope to learn more about patterns of use among gay men.

As part of the trial, Mr Downes is receiving Truvada at a reduced cost and says the experience has boosted his confidence.

"If somebody decides to take a condom off during sex with me, I know I have that extra barrier there," he said.

"It's more about taking back control over my sexual health rather than relying on other people to do it for me if I'm unaware of what's happening."

It's a little bit of a process but for me it's worth it.

Getting access to PrEP is difficult in Australia, especially for those who missed out on the Victorian trial and similar research projects in New South Wales and Queensland.

The Therapeutic Goods Administration is yet to give PrEP the green light, forcing men like Chris Williams to import the drug from overseas using a prescription from a doctor.

That can cost a staggering $750 a month.

Even the generic version is out of reach for many gay men, especially students and low-income earners.

In response, a social media campaign featuring a cast of people who are HIV positive has been launched in the hope of having PrEP added to the Pharmaceutical Benefits Scheme.

I had to come to terms with the fact that I am in some ways at risk of contracting HIV and [PrEP] can help me compensate for that.

The United States is the only country where PrEP is readily available and Noël Gordon, 24, considers himself lucky to be living there.

"Given that I am a black gay man, I live in Washington DC, which has high rates of HIV infection, I'm not in a monogamous relationship, I had to come to terms with the fact that I am in some ways at risk of contracting HIV," he told 7.30.

"This prevention tool, this strategy, could help me compensate for that."

The debate around PrEP in the US took a nasty turn recently when critics labelled advocates of the drug "Truvada whores" on social media.

But Mr Gordon rejects the suggestion gay men are using PrEP to justify their own promiscuity.

"I think the term 'Truvada whore' started because of people's general apprehension about PrEP or the idea that people would somehow use PrEP as an excuse or a justification to start having carefree sex with anyone and everyone," he said.

"Many people have tried to reclaim the term, in the same way we reclaimed the term 'queer' because they don't see themselves as being reckless, they don't see themselves as being carefree, but rather they see themselves as being empowered."

Back in the UK, there definitely was a stigma around it and people were viewed as being a slag just because they were going on it, when, in truth, they were being more careful and looking after themselves.

Patrick Jeffries disagrees with the way many PrEP users in the United Kingdom have been alienated by the gay community.

He believes the drug will make sex safer for gay men rather than encourage risky behaviour.

"There's a lack of information and education," Mr Jeffries said.

"I think people have been a bit ignorant to how things have changed.

"If it becomes readily available to everyone, I think that's a huge thing."

The 28-year-old is not yet using PrEP but while he does not consider himself high risk of contracting HIV, he might decide to give the drug a try.

"I've been single for quite a long time, I don't really go out and sleep around a lot but there's always just that extra benefit and safety involved in knowing you are covered," Mr Jeffries said.

What is PrEP? PrEP stands for pre-exposure prophylaxis, with prophylaxis meaning "to prevent or control the spread of an infection or disease"

PrEP is a HIV prevention method in which people who do not have HIV infection take a pill daily to reduce their risk

The pill is called Truvada and it contains two antiviral medicines that are also used to treat people who already have HIV infection

These drugs suppress the virus in people living with HIV

The effectiveness of using HIV antiretroviral drugs such as PrEP has been established by clinical trials conducted in gay men, heterosexual adults and injecting drug users

PrEP can be considered for people in populations who are at high risk of acquiring HIV, such as gay and other homosexually active men who are having multiple events of unprotected sex

It is also recommended for anyone who has been diagnosed with a sexually transmissible infection within the past six months, is in an ongoing relationship with a partner who is HIV positive, has injected illicit drugs and shared equipment or been in a treatment program for injection drug use in the past six months

Although PrEP has not been approved in Australia, Truvada can be legally imported from overseas for the purposes of preventative use under Australia's personal importation scheme Sources: Sources: ACON and AIDS.gov

Topics: aids-and-hiv, diseases-and-disorders, health, medical-research, australia