Auckland’s Lockdown Has Made PrEP Harder To Access

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Aucklanders are finding it difficult to access the safe sex drug following Lockdown, and Pharmac are slow to make the necessary adjustments to help.

Auckland’s ongoing COVID-19 restrictions have highlighted flaws in eligibility for Pre-exposure Prophylaxis (PreP).

PreP reduces the risk of HIV infection by 99 per cent. The drug is fully funded for those at risk of HIV, such as men who have sex with men.

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Under Pharmac rules, men who have sex with men must be sexually active within the three months of using PrEP and have had unprotected receptive anal sex with a casual partner.

Given Auckland surpassed three months of Lockdown restrictions, very few men in the region are now eligible to receive funded PrEP as a result of a ban on people meeting for casual sex.

One man impacted by the policy told RNZ he must lie to his doctor about his sexual history in order to continue to receive PrEP.

“I’ll just tell my doctor, ‘Yep, I’m at risk, I’d had unprotected sex, I’ve been a bottom [receptive sex]’, whether that’s true or not because I know he’ll tick the boxes I need to get it.”

He is forced to do so to avoid paying the full cost of PrEP which he cannot afford. The New Zealand Aids Foundation estimates the cost to be $183.45, “Honestly, financially, I probably couldn’t afford [to self-fund],” he said. “I would try and look at every road possible to not pay that.”

Dr Peter Saxton says the eligibility rules “absolutely” needed to be amended.

“Widening criteria would have the benefit of increasing PrEP uptake, it would widen the number of people who could take PrEP,” he said.

Pharmac director of operations Lisa Williams told RNZ that they were examining recommended changes to the eligibility criteria.  “The next step is for us to complete our economic assessment and compare this potential investment to other investments options in other medicines.”

However, Body Positive CEO Mark Fisher tells express they have been recommending that Pharmac removes the requirement, “Patient has had at least one episode of condomless receptive anal intercourse with one or more casual male partners in the last 3 months,” since September 2020 and this was supported by Pharmac’s Anti-infective subcommittee but Pharmac’s December 2021 Special Authority Criteria still shows ‘no mention’ of this review.

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