What’s Going On With Australia’s PrEP Shortage?

Australia is currently experiencing a shortage of extremely important HIV prevention medication Pre-exposure prophylaxis – more commonly known as PrEP.

PrEP is an antiretroviral medication taken by those – most commonly gay and bisexual men – who are at higher risk of sexually acquired human immunodeficiency virus, HIV 1.

The medication was hailed as a “gamechanger” when it became available on Australia’s Pharmaceutical Benefits Scheme (PBS) in 2108, because it has an efficacy rate of 99% for gay and bisexual men when used every day.

There have been widespread reports of pharmacies being unable to fill PrEP prescriptions because of the shortage, including in inner city Sydney and Melbourne.

A recent report says that between 1 April 2018 and 31 December 2022, a whopping 62,632 people received PBS-subsidised PrEP, and 97.9% of them were men.

A major group that takes PrEP is of course gay and bisexual men, so this shortage drastically impacts the Australia’s LGBTQIA+ community.

Australia’s PrEP shortage could last months

The Therapeutic Goods Administration (TGA) database confirms there are current shortages of several different brands of tenofovir/emtricitabine.

According to the TGA’s Medicine Shortages database, some of the medications won’t be available again for months.

The soonest available dates are the 11th and 30th of October, which are listed as ‘limited availability’, while other forms of the medication have expected supply dates listed as 8 November and 3 March, 2025.

LGBT health orgs’ advice on what to do if you’re affected by the PrEP shortage

“We understand news of a PrEP shortage is concerning for our communities, especially since we know a large portion of gay and bi+ men take the drug as their preferred HIV prevention strategy,” Thorne Harbour CEO Simon Ruth told Star Observer.

“However, daily PrEP isn’t the only way to prevent HIV. On-Demand PrEP is an equally effective solution for cisgender guys who want to make their current supply of PrEP last a bit longer. And we still have condoms, UVL, and PEP – all of which are effective strategies that some people even prefer to regular PrEP.”

Ruth said the shortage is affecting pharmacies in Australia, and so encouraged the LGBTQIA+ community not to stockpile, and for people who aren’t engaging in regular sexual activity to consider moving to an on-demand dosing schedule.”

“For those concerned about running out of regular PrEP, you can consider personal importation, a legitimate method of ordering the drug online from overseas pharmacies. We also want to see cooperation from Australian Border Force to ensure any personal importation isn’t unnecessarily held up,” said Ruth.

“We also understand that a new supplier of PrEP is in entering the market in the near future and there are other drugs that the TGA or the Minister for Health could fast track for use as PrEP – those are both viable options for addressing the current shortfall.”

ACON Director of HIV and Sexual Health, Matthew Vaughan delivered the following statement to Star Observer:

“Availability of the HIV prevention medication Pre-Exposure Prophylaxis (PrEP) has been affected due to a temporary national supply issue. This supply issue is impacting multiple suppliers to Australia.

“We have had contact with some of the suppliers of PrEP and we understand this issue will be resolved soon, with more supply expected to arrive within the coming months.

“At a state level, we are aware NSW Health are working to ensure access to HIV pre-exposure prophylaxis (PrEP) and HIV post-exposure prophylaxis (PEP) medication is available for those who need them.

“If people are currently taking PrEP, they are advised not to leave restocking medication to the last minute. Given the current situation, they may need to visit more than one pharmacy to find a supply, and there may be limitations on how many bottles of PrEP can be obtained from a pharmacy. People are encouraged to plan ahead to ensure their personal supplies don’t run out.

“If people are unable to obtain PrEP through local pharmacies, they can access it online via personal importation through platforms such as Green Cross Pharmacy. More information about online outlets is available through PrEP Access Now at pan.org.au/buy-prep-online. ACON is not aware of any supply issues with international suppliers and personal importation schemes.

“For people who are currently taking daily PrEP but are not engaging in regular or frequent sexual activity, they may want to consider whether an on-demand dosing schedule might be a suitable alternative during this time. This approach can help conserve supply while still providing the same high levels of protection when it’s needed, if taken as prescribed. More information on on-demand dosing can be found at endinghiv.org.au/blog/prep-on-demand-dosing-guide/.

“It is important to remember that outside of PrEP, other highly effective HIV prevention options are available. We know that people living with HIV who have an undetectable viral load are unable to pass on HIV to their sexual partners. Additionally, condoms remain a highly effective way to prevent HIV and other STIs.

“If people believe they have been exposed to HIV, they should start Post-Exposure Prophylaxis (PEP) as soon as possible, ideally within a few hours after the risk event.

“We hope this will be resolved in the coming months. In the meantime, we’re encouraging our communities to take the necessary steps to protect themselves and their sexual partners, which is something our communities have always done. We will continue to monitor the situation and will provide updates to our communities as more information becomes available.

“For this temporary shortage is limited to TD*/FTC (emtricitabine and tenofovir disoproxil) based combinations, which are commonly used for PrEP and PEP.

“It is unlikely that this shortage will affect people living with HIV as many people who were previously taking TDF/FTC-based regimens have been moved onto newer treatment options that are unaffected by this supply issue. ACON is not aware of any supply shortages linked to these combinations.

“People experiencing difficulty in accessing PrEP can call the NSW Sexual Health Info Link on 1800 451 624.”

Downward trend of HIV diagnoses in Australia

News of this shortage comes not long after the UNSW Kirby Institute reports that HIV diagnoses are trending downward.

While Australia actually had an increase of new HIV diagnoses according 2023 data, the Kirby Institute says that in the long-term, the numbers are trending down.

The overall reduction of HIV diagnoses is 33 percent over the last decades, but the Institute says diagnoses of Australian gay and bisexual men have been reduced by 64 percent within the same period of time.

“These long-term reductions tell us our strategies to eliminate HIV transmission – such as testing, HIV pre-exposure prophylaxis (PrEP) and treatment – are working,” said Dr Skye McGregor, lead of the surveillance innovation group at the Kirby Institute.

With this recent news, it tells us that pre-exposure medications like PrEP are more important than ever.