An Australian Man Who Was Using PrEP ‘On Demand’ Has Contracted HIV

For years now, PrEP has been a highly effective tool in the HIV prevention toolbox, not just for gay men but for all at-risk groups. The pill, also referred to by its brand name, Truvada, is nearly 100% effective in preventing seroconversion in those who take it daily, as directed. Now word has come down that an Aussie gay man who was using PrEP “on demand” has contracted HIV. We do not know whether his seroconversion was due to a medication-resistant strain of HIV or a lack of daily adherence to the drug, as proper PrEP use is key to its effectiveness.

The Aussie man, Steven Spencer opened up about his test results and spoke to local paper the Sydney Morning Herald about his story. He’s using his diagnosis as an opportunity to discuss HIV with the larger community.

Despite taking PrEP “on demand” for five years — meaning instead of taking the medication daily, he would only take it before and after having sex — the 27-year-old Sydney resident tested positive for HIV last December.

“On demand” PrEP use is supported by some medical professionals, while others stress daily adherence for maximum results. Darren Russell, an adviser for the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine — the organization that wrote Australia’s proper PrEP use guidelines — supports “on demand” use, saying, “Taking PrEP only around the time of sexual events allows for fewer tablets to be taken overall, resulting in less exposure to medication, potentially fewer side-effects, and lower costs.” Still, he encourages PrEP users to discuss proper PrEP use with their doctor.

“I was in complete shock, as were my doctors,” he says, referring to his newfound HIV diagnosis.

Still, he remains steadfast that this isn’t a reason for gay men (and other at-risk communities) to believe the drug’s effectiveness is compromised. “What happened to me doesn’t change the fact that PrEP is still the most powerful HIV preventative we have ever had,” he says. “It is protecting hundreds of thousands of people from HIV in an empowering way, alongside effective treatment for people living with HIV.”

He is the second person in Australia and only the seventh in the world to contract HIV while taking PrEP. He began HIV treatment immediately and within six weeks of the diagnosis he had achieved an undetectable viral load, which prevents him from transmitting the virus to anyone else.

We encourage anyone using Truvada to discuss proper PrEP use with their doctor.

Featured image of Steven Spencer by Greg Chilton via Sydney Morning Herald