Man contracts HIV while taking PrEP ‘on demand’

Steve Spencer, who is believed to be the second man in Australia to contract HIV while taking PrEP.

A man living in Sydney was diagnosed with HIV despite taking Pre-Exposure Prophylaxis (PrEP) drug.

Steve Spencer is believed to be the second person in Australia and the seventh person in the world to contract the virus while taking the drug, The Sydney Morning Herald reported on Thursday (March 21).

The 27-year-old had been taking PrEP for six years, following the “on demand” method, which means he took a higher dose before and in the 48 hours after a potential exposure to the virus.

“[PrEP] is so near perfect that it is amazing and I’ll always support it.”

— Steve Spencer

After his diagnosis in December, Spencer began HIV treatment. After six weeks his load was undetectable, meaning it cannot be transmitted through sex.

Spencer, who came out as HIV-positive on a float at the Sydney Mardi Gras—the annual LGBT+ Pride parade—decided to share his story publicly to fight the stigma and to keep advocating for PrEP.

“It is so near perfect that it is amazing and I’ll always support it,” he told Australian channel ABC, adding: “I’m not angry at all, I don’t hold a grudge at all.”

The Sydney Opera House in Australia, where the government began subsidising PrEP in 2018.

The Australian government began subsidising PrEP in 2018. (Don Arnold/Getty for RED)

PrEP has been found to drastically reduce HIV transmission during unprotected sexual encounters.

It is however not infallible, and it does not protect from any other sexually transmitted infection, such as gonorrhoea or chlamydia.

For this reason, advocates continue to promote condoms as the safest way to have sex, and regard PrEP as another tool in the sexual health arsenal that can help reach the groups that are most at-risk.

If a pill is taken every day, PrEP is more than 99 percent effective.

Bottles of antiretroviral drug Truvada are displayed at Jack's Pharmacy on November 23, 2010 in San Anselmo, California.

Antiretroviral drugs like Truvada can prevent the spread of HIV (Justin Sullivan/Getty)

As Australian Society for Sexual Health Medicines Associate Professor Edwina Wright told ABC, one trial has shown the “on demand” method can reduce the risk of HIV transmission by 86 percent.

Experts like Wright believe more testing needs to be done to see if it can be as effective as taking PrEP daily.

How can people access PrEP?

The PrEP drug Truvada, produced and sold by biopharmaceutical giant Gilead, has seen a massive uptake by the gay community globally over the past few years and various governments around the world have begun subsidising it in an effort to tackle the spread of HIV. 

The Australian government began subsidising the cost of PrEP across the entire country a year ago, adding it to a list of eligible medications for the Pharmaceutical Benefits Scheme, which subsidises the cost of prescription drugs for Australians.

In the UK, PrEP has been linked to a dramatic fall in numbers of HIV diagnosis among men who have sex with men (MSM), a result Public Health England in 2017 called “the most exciting development in the UK HIV epidemic in 20 years”.