[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-400883-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-400883-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","implementing-hiv-preexposure-prophylaxis-prep-lets-not-get-caught-with-our-pants-down","Implementing HIV preexposure prophylaxis (PrEP) - let’s not get caught with our pants down","","HIV pre-exposure prophylaxis (PrEP) is a daily pill that prevents HIV acquisition, and New Zealand publicly funded it in March 2018 for individuals at high risk. PrEP can substantially improve HIV control, yet many clinicians and planners lack familiarity, threatening effective uptake. The article reviews PrEP’s rationale and highlights barriers including awareness, acceptability, scale-up goals, prescribing and pharmacy bottlenecks, service capacity, training, monitoring systems, equity, eligibility, risk compensation, and policy, calling for research and innovation to advance HIV elimination in Aotearoa/New Zealand.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/implementing-hiv-preexposure-prophylaxis-prep-lets-not-get-caught-with-our-pants-down/400883/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/implementing-hiv-preexposure-prophylaxis-prep-lets-not-get-caught-with-our-pants-down/400883.png","ImageObject",300,407,{"name":42,"@type":43},"Stanley","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-09-29","2026-09-27",true,{"@type":52,"interactionType":53,"userInteractionCount":26},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What is HIV pre-exposure prophylaxis (PrEP) and what does it do?","Question",{"text":62,"@type":63},"PrEP is a daily pill containing tenofovir disoproxil fumarate with emtricitabine (TDF/FTC). When taken as prescribed, it almost entirely eliminates the risk of HIV acquisition.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"Who is eligible for publicly funded PrEP in New Zealand as of 1 March 2018?",{"text":67,"@type":63},"Eligible populations include gay and bisexual men and transgender individuals at high risk, and partners of people living with unsuppressed HIV. Eligibility is defined using criteria such as confirmed HIV-negative status plus specified risk behaviors or partner viral load/condom use conditions.",{"name":69,"@type":60,"acceptedAnswer":70},"What main barriers can slow rapid PrEP implementation?",{"text":71,"@type":63},"Key barriers include limited awareness among consumers and health practitioners, acceptability issues, scale-up targets, prescribing and pharmacy bottlenecks, insufficient service capacity for follow-up, primary care training needs, monitoring systems for uptake and quality, and equity-related concerns such as eligibility, risk compensation, and policy.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},400883,1790672926,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":26,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":123,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144},2336477405376,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Implementing HIV preexposure prophylaxis (PrEP): let’s not get caught with our pants down  \nPeter J Saxton, Massimo Giola, Edward P Coughlan, Joseph G Rich, Sunita Azariah, Adrian H Ludlam, Christy O’Toole, Mike Pohl,  \nJason M Myers  \nABSTRACT  \nHIV pre-exposure prophylaxis (PrEP) is a daily pill that prevents HIV acquisition. In March 2018, New Zealand became one of the first countries in the world to publicly fund PrEP for individuals at high risk. PrEP promises significantly improved HIV control but is unfamiliar to most health practitioners here, compromising its potential. In this article we review the rationale for PrEP and identify barriers to rapid implementation. The latter include: consumer and health practitioner awareness; acceptability; scale-up targets; prescribing and pharmacy bottlenecks; service capacity to manage follow-up; primary care training; monitoring systems for uptake and quality; equity; eligibility; risk compensation and policy. Many of these areas are ripe for research and innovation. By addressing these obstacles we can realise the potential of PrEP and move closer to ending HIV in Aotearoa/New Zealand.  \nHIV pre-exposure prophylaxis (PrEP)  \nis a daily pill containing tenofovir  \ndisoproxil fumarate with emtricitabine (TDF/FTC) that almost entirely eliminates the risk of HIV acquisition if taken as prescribed. On 1 March 2018 New Zealand became one of the first countries internationally to publicly fund PrEP.1 Eligible populations include gay and bisexual men (GBM) and transgender individuals at high risk, and the partners of people living with unsuppressed HIV (Figure 1) . PHARMAC’s decision is timely as New Zealand’s HIV epidemic expands in size and cost.2 Substantial reductions in HIV transmission are possible; New South Wales (NSW) has witnessed a 29% decline in newly-acquired HIV diagnoses following implementation of a large PrEP demonstration project.3  \nPrEP may be the latest innovation in HIV prevention but is unfamiliar to most health practitioners and planners in New Zealand: we have brand new trousers, but no belt or suspenders. To achieve a good fit, we can learn from overseas programmes and replicate and adapt efficient systems locally,  \nespecially rapid scale-up. PrEP is also novel for New Zealand because it is a biomedical approach that shifts HIV prevention for HIV negative individuals from communities into the clinical setting and will therefore rely heavily on engagement by primary care, pharmacies and sexual health services.4 In this viewpoint article we review the rationale for PrEP and raise initial uncertainties about implementation.  \nRationale for PrEP PrEP is e ective if taken correctly  \nPrEP almost entirely eliminates the risk of contracting HIV sexually if taken as prescribed. Open-label prospective cohort studies in sexual health clinics found that PrEP reduced HIV acquisition risk among GBM by 86%.5,6 With correct timing and daily adherence this risk reduction approached 99% .7 Imperfect adherence (four or more times a week) still conveyed considerable if not complete protection,8 earning PrEP a reputation for being a“forgiving” medication – which is relevant when considering “real-world” use.  \nFigure 1: Eligibility criteria for initiating funded HIV PrEP (1 March 2018) .  \nBoth:  \n1. Patient has tested HIV negative; and  \n2. Either:  \n2.1 All of the following:  \n2.1.1 Patient is male or transgender; and  \n2.1.2 Patient has sex with men; and  \n2.1.3 Patient is likely to have multiple episodes of condomless anal intercourse in the next 3 months; and  \n2.1.4 Any of the following:  \n2.1.4.1 Patient has had at least one episode of condomless receptive anal intercourse with one or more casual male partners in the last 3 months; or  \n2.1.4.2 A diagnosis of rectal chlamydia, rectal gonorrhoea, or infectious syphilis within the last 3 months; or  \n2.1.4.3 Patient has used methamphetamine in the last three months; or  \n2.2 All of the following:  \n2.2.1 Patient has a regular pa","cbCaig3XqW0MYFwM","https://ap.wps.com/l/cbCaig3XqW0MYFwM","pdf",532941,"English","# Abstract\n# HIV pre-exposure prophylaxis (PrEP)\n## Eligibility criteria for initiating funded HIV PrEP (1 March 2018)\n# Rationale for PrEP\n## PrEP is effective if taken correctly\n## Effectiveness data at the population level\n## PrEP is timely\n## PrEP is moral","[{\"question\":\"What is HIV pre-exposure prophylaxis (PrEP) and what does it do?\",\"answer\":\"PrEP is a daily pill containing tenofovir disoproxil fumarate with emtricitabine (TDF/FTC). When taken as prescribed, it almost entirely eliminates the risk of HIV acquisition.\"},{\"question\":\"Who is eligible for publicly funded PrEP in New Zealand as of 1 March 2018?\",\"answer\":\"Eligible populations include gay and bisexual men and transgender individuals at high risk, and partners of people living with unsuppressed HIV. Eligibility is defined using criteria such as confirmed HIV-negative status plus specified risk behaviors or partner viral load/condom use conditions.\"},{\"question\":\"What main barriers can slow rapid PrEP implementation?\",\"answer\":\"Key barriers include limited awareness among consumers and health practitioners, acceptability issues, scale-up targets, prescribing and pharmacy bottlenecks, insufficient service capacity for follow-up, primary care training needs, monitoring systems for uptake and quality, and equity-related concerns such as eligibility, risk compensation, and policy.\"}]","Implementing HIV preexposure prophylaxis (PrEP) - let’s not get caught with our pants down | PDF",1790514966,25]