Study: Culturally-tailored approaches for PrEP access needed

A world-first global review led by Monash University reveals that migrant populations may be at greater risk of HIV infection because of reduced access to prevention measures such as pre-exposure prophylaxis (PrEP).

PrEP, an antiretroviral tablet available by prescription and taken to prevent HIV infection, is said to be up to 99% effective in preventing HIV.

Published in The Lancet Public Health, the study identified barriers that migrant populations in Australia and around the world face to access PrEP.

These barriers include:

  • lack of awareness,
  • low risk perception for HIV, and
  • service issues such as cost and provider discrimination.

Migrant populations may also face uncertainty in navigating the health system and stigma around HIV, gay and bisexual identities and using PrEP.

Senior author and Melbourne Sexual Health Centre physician, Monash University Central Clinical School Associate Professor Jason Ong, says a concerning number of migrants are being left behind in the HIV response compared to those who are Australian-born.

He says the study identifies the need for culturally-tailored approaches for PrEP access, and to address migration and HIV-related discriminatory policies, including making it much harder for people with HIV to obtain permanent residency.

“Navigating the landscape of HIV prevention is like traversing a maze, with barriers blocking the way at every turn,” Associate Professor Ong said.

“Culturally tailored approaches act as guiding lights, illuminating the path forward.

“To improve health inequities, we suggest strategies at societal, service and individual levels that address the barriers of using PrEP among those who would benefit from it the most.”

Associate Professor Ong says PrEP was “game-changing” in preventing HIV.

“Getting this into the hands of the right people remains a significant barrier in our fight against HIV,” he said. “Our study shows that it is possible to improve health inequity in our society if we can direct resources to the right people.”

Professor Darryl O’Donnell, the CEO of Health Equity Matters concurred.

“We know PrEP is highly effective in preventing HIV. Australia has made PrEP available at a low cost to its own citizens.

“We have a national goal of virtually eliminating HIV transmission.

“We will only achieve this if PrEP is available to all who can benefit, including people migrating to Australia,” Professor O’Donnell said.

For more on PrEP, visit: healthdirect.gov.au/Pre-exposure-prophylaxis-PrEP.