PrEP, PEP & U=U: Your Plain-English Guide to HIV Prevention in 2026

Pillar 1: PrEP — preventing HIV before exposure

PrEP stands for Pre-Exposure Prophylaxis. It’s a daily pill (usually Truvada or
Descovy) that’s over 99% effective at preventing HIV when taken correctly. Approved by the TGA in 2018,
listed on the PBS in 2018, and now widely accessible through GPs across Australia. Most users on PBS
PrEP pay $7.30–$31.60 per month. Cranbourne West Medical Centre has S100-accredited prescribers
including Nurse Practitioner Daniel Sankar.

Who should consider PrEP?

PrEP is suitable for anyone at ongoing risk of HIV exposure. Common candidates include: men who have
sex with men (MSM) without consistent condom use, sex workers, people with an HIV-positive partner who
isn’t on treatment, people with multiple partners. PrEP is bulk-billed for the consultation; the
medication is PBS-subsidised.

PrEP — daily vs on-demand

Daily PrEP is the most common — one tablet every day. Maximum protection regardless of
when sex happens. On-demand PrEP (also called 2+1+1) — 2 tablets 2–24 hours before sex,
1 tablet 24 hours later, 1 tablet 48 hours later. Only suitable for men who have sex with men. Discuss
with your GP which is right for you.

Pillar 2: PEP — emergency HIV prevention after exposure

PEP stands for Post-Exposure Prophylaxis. It’s a 28-day course of HIV antiretrovirals
taken AFTER possible exposure. Effective if started within 72 hours — sooner is better. Common reasons
for PEP: condom break or no condom with someone of unknown HIV status, sexual assault, needle-stick
injury, accidental exposure to HIV-positive blood. PEP is essentially the “morning-after pill” for HIV.
Walk in to Cranbourne West Medical Centre or call (03) 7017 5932 if you need PEP — speed
matters.

PEP — what to expect

Initial consultation includes a brief history, baseline blood tests (HIV, Hep B, Hep C, kidney
function), and a starter pack of medications. Side effects are usually mild (nausea, headache, fatigue)
and improve after the first week. Follow-up at 4 weeks and 12 weeks for repeat HIV testing. PEP is
bulk-billed for eligible patients.

Pillar 3: U=U — Undetectable equals Untransmittable

If a person living with HIV takes their antiretroviral medication consistently and their viral load is
undetectable for at least 6 months, they cannot transmit HIV sexually. This is called U=U:
Undetectable = Untransmittable. Endorsed by the WHO, UNAIDS, the CDC, and Australia’s leading
HIV organisations. This is one of the most important medical breakthroughs of the past decade — and ends
decades of stigma. People living with HIV on treatment are not infectious.

How HIV testing works in 2026

Modern fourth-generation HIV tests (Combo HIV-1/2 antibody/antigen) detect infection from about 14 days
after exposure. Self-test kits are available at pharmacies. At Cranbourne West, HIV testing is
bulk-billed and confidential — results in 5–7 days. If you’ve had a possible exposure: Get
tested. Don’t assume. Many infections are asymptomatic in early stages.

What’s coming — long-acting injectable PrEP

Cabotegravir-rilpivirine long-acting injection (Cabenuva for HIV treatment) and cabotegravir for PrEP
(Apretude) are showing great promise — a once-every-2-month injection instead of a daily pill. As of
2026, these aren’t yet PBS-listed but trials are underway. Watch this space.

Reducing stigma is part of prevention

HIV stigma kills more people than HIV itself in 2026. Stigma stops people getting tested, taking PrEP,
or starting treatment. The Cranbourne West Medical Centre SHIP clinic is explicitly judgement-free,
LGBTQIA+ affirming, and welcoming to anyone — regardless of orientation, identity, or behaviour. If
you’re worried about anything sexual-health related, walk in. We’ve heard it all.