HIV PrEP in General Practice: Prescribing and Reducing Stigma with Dr Brad McKay

In this episode of The Good GP, host Dr Krystyna de Lange is joined by Dr Brad McKay, a Sydney-based GP with extensive experience in HIV treatment, to discuss HIV pre-exposure prophylaxis (PrEP) and its vital role in general practice. This episode is produced in collaboration with the Australian Society of HIV, Viral Hepatitis and Sexual Health Medicine (ASHM).

Dr McKay provides an in-depth overview of what PrEP is, who it is suitable for, and addresses common misconceptions about patient eligibility. Discussing that while PrEP has traditionally been targeted towards gay men and men who have sex with men, there are other groups at risk of HIV who may benefit, including heterosexual individuals, people with partners living with HIV, and people who inject drugs. They emphasise the importance of a non-judgmental and inclusive approach, encouraging GPs to routinely take sexual histories and offer PrEP when appropriate, reducing stigma and improving patient outcomes.

Providing practical guidance on baseline investigations, including HIV, Hepatitis B and C, syphilis, gonorrhoea, chlamydia screening, and renal function assessment. Dr McKay explains the considerations for both daily and on-demand PrEP regimens, outlining which patients are suitable for each based on sexual practices, and addresses key points around adherence and management of missed doses. He also touches on newer options such as long-acting injectable PrEP, providing insights into future directions for HIV prevention in Australia.

Includes advice for GPs on ongoing follow-up, including recommendations for quarterly review, repeat sexual health screening, and renal monitoring.

Links & Resources:

• ASHM HIV PrEP Decision Making Tool: https://ashm.org.au/wp-content/uploads/2025/07/ASHM_HIV_PrEPtool__July-2025_WEB.pdf
• ASHM National PrEP Guideline: https://ashm.org.au/wp-content/uploads/2025/08/ASHM-PrEP-guidelines-2025_FINAL.pdf
• PrEP Access Now website: https://www.pan.org.au/

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