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HIV PrEP: eligibility, dosing options, baseline tests, and monitoring

A detailed Australian summary of hiv prep: eligibility, dosing options, baseline tests, and monitoring, with source-attributed priorities, a practical workflow, safety escalation and state or territory implementation boundaries.

JurisdictionAustralia
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Australia
This is an iatroX educational summary of named Australia sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. Apply current TGA product information, PBS restrictions, state or territory law, local referral criteria, formulary and antimicrobial policy. A national recommendation does not create uniform service access.

Scope

Offer PrEP to HIV-negative people with ongoing sexual or injecting risk using shared assessment rather than identity-based assumptions. Before starting, exclude current HIV including recent exposure or acute retroviral symptoms, and assess kidney function, hepatitis B, STI and pregnancy. This summary is limited to the population, decisions and escalation boundaries stated in the named source.
sources for this section:ASHM National PrEP Guidelines 2025

The Bottom Line

  • Offer PrEP to HIV-negative people with ongoing sexual or injecting risk using shared assessment rather than identity-based assumptions.
  • Before starting, exclude current HIV including recent exposure or acute retroviral symptoms, and assess kidney function, hepatitis B, STI and pregnancy.
  • Hepatitis B surface antigen positivity changes stopping safety because tenofovir-containing PrEP also suppresses HBV and abrupt cessation can flare hepatitis.
  • Choose daily or event-based dosing only within the Australian guideline population and ensure hepatitis B and adherence implications are understood.
sources for this section:ASHM National PrEP Guidelines 2025

Practical clinical workflow

1

Topic-specific assessment action

Offer PrEP to HIV-negative people with ongoing sexual or injecting risk using shared assessment rather than identity-based assumptions.
2

Topic-specific diagnostic action

Choose daily or event-based dosing only within the Australian guideline population and ensure hepatitis B and adherence implications are understood.
3

Topic-specific management action

Review at the national interval for HIV testing, adherence, side effects, kidney monitoring, STI screening, vaccination and changing prevention needs.
4

Topic-specific follow-through

Event-based PrEP is not supported for every sex or exposure type and must stay within the national guideline population.
sources for this section:ASHM National PrEP Guidelines 2025

Safety boundaries and escalation

  • Do not start PrEP alone when acute HIV is possible; arrange urgent diagnostic testing and specialist advice to avoid functional monotherapy and resistance.
  • Discuss condoms, doxycycline strategies only where current guidance supports them, vaccination and regular STI screening as a combined prevention plan.
sources for this section:ASHM National PrEP Guidelines 2025

Implementation

The named source is national or binational guidance used in Australia, but referral access, public-health directions, formularies and funded services can still differ by state, territory and health service. Check current TGA product information for medicines. Offer culturally safe care and use the NACCHO鈥揜ACGP National Guide where Aboriginal and Torres Strait Islander preventive or chronic-care recommendations differ.
sources for this section:ASHM National PrEP Guidelines 2025

Clinical use boundary

This independently written summary is not an official guideline. Check the linked source version, current TGA-approved product information where medicines are involved, and the applicable state, territory and local pathway at the point of care.

sources for this section:ASHM National PrEP Guidelines 2025

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Australasian Society for HIV, Viral Hepatitis and Sexual Health MedicineASHM National PrEP Guidelines 2025: Prevent HIV by Prescribing PrEPNational guideline published August 2025; checked 2026-08-20 路 accessed 2026-08-20
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