Auckland DHB tells express that “the screening, prevention and treatment of HIV is a priority” refuting claims that some men have been turned away from accessing PrEP at their clinics.
The Auckland District Health Board have denied accusations that recent policy changes have left gay and bisexual men in Auckland with limited access to PrEP.
When PrEP was first funded in early 2018, patients initially needed to be seen by a specialist (a named HIV prescriber) to receive it. Many patients self-presented or were referred to the Auckland Sexual Health Service to receive PrEP.
In late 2019 the PHARMAC requirement for a specialist to endorse each case was removed, meaning GPs were able to start providing new and repeat PrEP prescriptions.
While that is welcomed by some PrEP users who are out to their GPs, a number of gay men express spoke to say the new policy means many gay and bisexual men who had previously used Auckland sexual health clinics were now being “pushed” towards their GPs for PrEP prescriptions even when they were not out to their GPs.
One told express that the new policy was an issue even for gay and bisexual men who were out to their GP as obtaining the drug meant explaining aspects of their sexual behaviour they may not be comfortable discussing with their local doctor.
“Even if you are out to your GP, to get PrEP you have to basically tell them, I’m a big bottom slut” one community member told express.
It’s just an “extra step of discouragement!”
A spokesperson for the Auckland DHB says the new policy is designed to “bring care closer to home” given the Auckland Sexual Health Service is a secondary care service.
“Often long-term PrEP patients also have other health issues that are best monitored and investigated with the involvement of their GP. Their local general practice is best placed to manage and provide this, to ensure care that is as close to home as possible and has continuity.” A spokesperson told express.
“As with all specialist services, the service users are usually referred back to their GP once their specialist needs have been met. This then means that Auckland Sexual Health Service’s specialist secondary services are made available for those who have the greatest need for them.”
The DHB says that it is aware that there are issues for some gay and bisexual men in discussing PrEP with their doctors and have discretion as to whether or not they discharge PrEP patients back to their primary care providers and will only do so when PrEP patients are “engaged with their GP, are out to their GP and feel comfortable discussing sex and sexuality-related issues with them.”
“We acknowledge that when patients move from a specialist service back to a primary care provider that this may be an unsettling time for some of them. We would like to assure patients that their Auckland Sexual Health Service clinician will contact their GP to ensure a smooth handover of care and if the need arises, they can self-present or be referred to the Auckland Sexual Health Service again in the future.” A DHB spokesperson tells express.
While there is generally a cost associated with visiting a GP, the Auckland DHB spokesperson says that those with financial difficulty will not be turned away from accessing PrEP through Auckland sexual health clinics.
In addition to those on low incomes, the clinics will continue to see follow up patients for “targeted groups who may be considered to have increased barriers to accessing health care” such as under 25s, transgender people, commercial sex workers, chem sex users and those with a very high frequency of sexual contacts (more than 30 different partners per month).”
Those who do not fit these criteria could find themselves paying up to an extra $240 per year to access PrEP.