Enhancing Access to HIV Pre-exposure Prophylaxis (PrEP) Through a Community-based Project in New Zealand

Lessing, Charon; Fisher, Mark; Hillebrand, Harry; Hannon, Robbie

doi:10.1071/HC26104

Enhancing Access to HIV Pre-exposure Prophylaxis (PrEP) Through a Community-based Project in New Zealand

Files

Journal article

Size: 525.82 KB, File format: Adobe PDF

Date

2026-07-24

Authors

Lessing, Charon

Fisher, Mark

Hillebrand, Harry

Hannon, Robbie

Item type

Journal Article

Publisher

CSIRO Publishing

Abstract

INTRODUCTION: New Zealand has maintained a low HIV prevalence through comprehensive screening, treatment, and prevention programmes. However, challenges remain with access to pre-exposure prophylaxis (PrEP) for at-risk populations, particularly men who have sex with men (MSM). AIM: This study aimed to evaluate the implementation and outcomes of a community-based project that expanded PrEP access via a Standing Order authorising peer HIV testers and pharmacists to initiate short-term PrEP prior to general practitioner follow-up. METHODS: Conducted between May 2020 and July 2021, the project involved collaboration between a community-based HIV support organisation, a general medical practice, and a community pharmacy in Auckland. Participants received an initial 10-day PrEP supply following a negative HIV rapid test and screening for contraindications, with follow-up laboratory testing and prescriptions managed by the practitioner and pharmacist team. RESULTS: Thirty-six clients enrolled (aged 22-60 years). Most identified as European (n = 16), Asian (n = 10), or Māori (n = 8). No participants seroconverted to HIV during the study. Six sexually transmitted infections were diagnosed and treated. A degree of hepatocellular damage was reported in one participant, and mild but transient liver enzyme elevation occurred in a further five participants. No renal toxicity was recorded. The mean duration of PrEP use was approximately 12 months. DISCUSSION: This project demonstrated that community-initiated PrEP under a Standing Order can be a safe, acceptable, and effective method for expanding HIV prevention services amongst MSM. This model supports future policy directions to broaden PrEP access through trained pharmacists and community channels.

Keywords

HIV prevention, New Zealand, PrEP, community pharmacy, pre-exposure prophylaxis, primary care, sexual health, standing order, 4206 Public Health, 42 Health Sciences, Clinical Research, Health Disparities and Racial or Ethnic Minority Health Research, Sexually Transmitted Infections, Mental Health, Health Services, HIV/AIDS, Prevention, Infectious Diseases, Sexual and Gender Minorities (SGM/LGBT*), Health Disparities, Minority Health, Infection, 3 Good Health and Well Being, 1110 Nursing, 1117 Public Health and Health Services, 4203 Health services and systems