Human Immunodeficiency Virus (HIV) is a virus that attacks the body's immune system, specifically targeting CD4+ T cells, which are crucial for fighting infections and diseases. When HIV enters the bloodstream, it hijacks these immune cells to replicate itself, gradually weakening the body's natural defence mechanisms. Without proper treatment, HIV progressively destroys the immune system, making individuals vulnerable to opportunistic infections and certain cancers that a healthy immune system would normally prevent.
HIV and AIDS are related but distinct conditions that are often confused. HIV is the virus itself, whilst AIDS (Acquired Immunodeficiency Syndrome) represents the advanced stage of HIV infection. A person develops AIDS when their CD4+ cell count drops below 200 cells per microlitre or when they develop specific opportunistic infections. With modern antiretroviral therapy available in Australia, many people living with HIV never progress to AIDS and can maintain healthy immune systems throughout their lives.
HIV transmission occurs through specific bodily fluids including blood, semen, vaginal secretions, and breast milk. Common transmission routes include unprotected sexual contact, sharing needles, and mother-to-child transmission during pregnancy or breastfeeding. Prevention strategies in Australia include:
Early HIV detection through regular testing is crucial for optimal health outcomes and preventing transmission to others. In Australia, free and confidential HIV testing is widely available through GP clinics, sexual health centres, and community testing services. Early diagnosis allows for prompt initiation of antiretroviral therapy, which can reduce viral load to undetectable levels. When viral load is undetectable, the virus cannot be transmitted to sexual partners, supporting the U=U (Undetectable = Untransmittable) principle recognised by Australian health authorities.
Antiretroviral therapy (ART) is the cornerstone of HIV treatment in Australia, consisting of a combination of medications that suppress viral replication and restore immune function. Modern ART regimens typically combine drugs from different classes to prevent viral resistance and achieve undetectable viral loads. The Pharmaceutical Benefits Scheme (PBS) subsidises most HIV medications, making treatment accessible and affordable for eligible Australian residents. With proper adherence, ART enables people with HIV to live long, healthy lives.
NRTIs are a fundamental class of HIV medications that block reverse transcriptase, an enzyme HIV needs to replicate. In Australia, commonly prescribed NRTIs include Zidovudine (AZT), one of the first HIV drugs developed, and Emtricitabine (FTC), which forms part of many modern combination therapies. These medications are often combined with other drug classes in single-tablet regimens, improving convenience and adherence. Emtricitabine is also used in pre-exposure prophylaxis (PrEP) formulations available through Australian healthcare providers for HIV prevention in high-risk individuals.
NNRTIs work by blocking the reverse transcriptase enzyme, preventing HIV from replicating within CD4+ T cells. Efavirenz remains a cornerstone treatment, often prescribed as part of combination therapy due to its proven efficacy and tolerability profile. Rilpivirine offers an alternative option, particularly suitable for treatment-naïve patients with lower viral loads. Both medications are available through Australian pharmacies and are listed on the Pharmaceutical Benefits Scheme (PBS), making them accessible treatment options for eligible patients across Australia.
Protease inhibitors target the protease enzyme essential for HIV viral maturation, effectively preventing the virus from producing infectious particles. Atazanavir is typically administered once daily with ritonavir boosting, offering convenient dosing for improved patient adherence. Darunavir demonstrates high barrier to resistance and excellent efficacy against both treatment-naïve and treatment-experienced patients. These medications are readily available through Australian pharmacies and require prescription from qualified healthcare providers. Both drugs are PBS-subsidised, ensuring affordability for patients meeting eligibility criteria throughout Australia.
Integrase inhibitors represent the newest class of antiretroviral medications, blocking HIV's ability to integrate its genetic material into host cell DNA. Dolutegravir offers superior resistance barrier and minimal drug interactions, making it a preferred first-line treatment option in current Australian guidelines. Raltegravir provides effective viral suppression with twice-daily dosing and established safety profile. These modern treatments are available through Australian pharmacies with PBS coverage, offering patients highly effective options with favourable side effect profiles and excellent treatment outcomes.
Single-tablet regimens revolutionise HIV treatment by combining multiple active ingredients into one daily pill, significantly improving patient adherence and quality of life. These fixed-dose combinations reduce pill burden whilst maintaining therapeutic efficacy. Australian patients can access various single-tablet options through PBS-approved prescriptions from specialist physicians. The convenience of once-daily dosing helps patients maintain consistent treatment schedules, leading to better viral suppression outcomes. These regimens are particularly beneficial for busy lifestyles and reduce the complexity of managing multiple medications daily.
Several proven combination therapies are available across Australian pharmacies, each offering unique benefits for different patient populations. Key options include:
These combinations are carefully formulated to maximise therapeutic benefit whilst minimising potential drug interactions and side effects, providing Australian patients with convenient, effective treatment options.
Pre-exposure prophylaxis (PrEP) is a daily medication taken by HIV-negative individuals to prevent HIV infection. PrEP is highly effective when taken consistently, reducing the risk of HIV transmission by up to 99%. It's recommended for people at high risk of HIV exposure, including men who have sex with men, individuals with HIV-positive partners, people who inject drugs, and those engaging in unprotected sex with multiple partners. Speak with your healthcare provider to determine if PrEP is suitable for your circumstances.
In Australia, two medications are approved for PrEP: Truvada (tenofovir/emtricitabine) and Descovy (tenofovir alafenamide/emtricitabine). Both are available on the Pharmaceutical Benefits Scheme (PBS), making them more affordable for eligible patients. Truvada has been the standard PrEP medication for years, whilst Descovy offers similar efficacy with potentially fewer side effects on kidney and bone health. Your doctor will help determine which option is most appropriate based on your medical history and individual needs.
Post-exposure prophylaxis (PEP) is an emergency treatment used after potential HIV exposure. PEP must be started within 72 hours of exposure, with earlier initiation being more effective. The treatment involves taking antiretroviral medications for 28 days. PEP is available through hospital emergency departments, sexual health clinics, and some GPs across Australia. If you believe you've been exposed to HIV, seek medical attention immediately as time is critical for PEP effectiveness.
Modern HIV medications are generally well-tolerated, but some side effects may occur. Common side effects include:
Most side effects are mild and temporary, often improving within the first few weeks of treatment. If you experience persistent or severe side effects, consult your healthcare provider as alternative medications may be available.
HIV medications can interact with other prescription drugs, over-the-counter medicines, and herbal supplements. Common interactions occur with antacids, certain antibiotics, and some heart medications. Always inform your pharmacist and healthcare providers about all medications you're taking, including vitamins and supplements. Some HIV medications may affect kidney or liver function, requiring regular monitoring through blood tests.
Taking HIV medications exactly as prescribed is crucial for treatment success. Consistent adherence helps maintain undetectable viral loads, prevents drug resistance, and ensures optimal health outcomes. Missing doses can allow the virus to multiply and potentially develop resistance to medications. Use pill organisers, phone reminders, or apps to help maintain your routine. If you're struggling with adherence, discuss strategies with your healthcare team.
HIV medications are subsidised under Australia's Pharmaceutical Benefits Scheme (PBS), significantly reducing costs for patients. Most HIV treatments are available at standard PBS prices, with further reductions for concession card holders. Medicare covers consultations with HIV specialists and regular monitoring tests. Some newer medications may require special authority approval from your doctor. Check with your pharmacist about current PBS listings and any applicable patient assistance programmes.
Regular consultations with HIV specialists or experienced GPs are essential for optimal HIV management. These appointments allow for monitoring of viral load, immune function, and potential side effects. Healthcare providers can adjust treatments as needed and provide guidance on lifestyle factors affecting your health.
Australia offers comprehensive support services for people living with HIV. Key organisations include the Australian Federation of AIDS Organisations (AFAO), state-based AIDS councils, and Positive Life groups. These services provide counselling, peer support, educational resources, and advocacy. Many offer online resources, support groups, and telephone helplines for ongoing assistance.
