Pre-Exposure Prophylaxis (PrEP) for Human Immunodeficiency Virus (HIV)

Developed in collaboration with CASA Medical.

Pre-exposure prophylaxis (PrEP) is a highly effective method of human immunodeficiency virus (HIV) prevention using HIV medications. It is 99% effective if used correctly.

This guideline refers to PrEP treatments that include:

• Regular daily dosing regimen with tenofovir disoproxil/emtricitabine (TD/FTC)
• “On-demand” dosing with TD/FTC
• Injectable long-acting cabotegravir (CAB-LA) 

“Start-up syndrome” (headache, weight loss /weight gain, fatigue and gastrointestinal upset) is the most common safety relevant problem on commencement of therapy and usually resolves within the first month of taking PrEP.

Ongoing regular review with a treating health professional is required. This is typically two monthly with CAB-LA and three monthly with TD/TFC PrEP. 

Pilot and controller information

• Pilots or controllers must cease flying or operating on commencement of PrEP for a minimum period of 2 weeks to assess medication suitability and side effects.
• Pilots and controllers should contact their ME or CAA AvMed when starting PrEP.
• The occurrence of any safety relevant side effects or abnormal testing results will require cessation from flying or operating and review by a ME.

For more information, see Medical Manual: HIV - Pre-Exposure Prophylaxis (PrEP).