EPIC-NSW stands for ‘Expanded PrEP Implementation in Communities in NSW’.

Page03EPIC-NSW is a study run by the Kirby Institute and funded by the NSW Government, in collaboration with a number of partners such as sexual health services and clinics. EPIC-NSW aims to assess the impact of the rapid expansion in access to PrEP amongst those at highest risk of acquiring HIV, in particular, if it will lead to a drop in new HIV infections.

The study aimed to enroll the majority of people in NSW who are at high risk of HIV infection as rapidly as possible in order to have the biggest impact on reducing new HIV infections in NSW. The study enrolled 3,700 participants at the end of October 2016. At that date, it was clear there was ongoing demand for PrEP from high-risk individuals in the community, so study recruitment was extended beyond 3,700 without a cap. Over 9,700 participants were enrolled by 30 April 2018. Enrolment stopped on 30 April 2018 because PrEP became accessible via the Australian Pharmaceutical Benefits Scheme (PBS) on 1 April 2018. EPIC-NSW was a criteria-based access program which means eligibility for the study will be determined on the basis of HIV risk criteria.

EPIC-NSW enrolment in the ACT was completed on 28 February 2018. Participants in the ACT sites will be provided up to 15 months of PrEP.

If you are an EPIC-NSW study participant, your date of enrolment into EPIC-NSW will determine when you receive your last supply of study PrEP.
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For details, including how you may continue to take PrEP outside the EPIC-NSW study, please discuss with your study doctor.

Partners involved in the study include the Kirby Institute, UNSW (leading the study), NSW Health and Local Health Districts, ACT HealthACON, Positive Life NSW, the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (Australia’s HIV professional organisation for clinicians) General Practitioners who specialise in HIV, NSW publicly funded sexual health clinics and private practices.

It is important to note that this study is not evaluating the effectiveness of PrEP itself, as this has already been demonstrated in a number of studies. Rather this study is investigating how PrEP is best implemented to maximise its impact at a population level.

The study has Human Research Ethics approval from the St Vincent’s Hospital Sydney Human Research Ethics Committee and from ACON’s Ethics Committee.

Who is eligible for the EPIC–NSW Study?

Eligibility for EPIC-NSW was based on the NSW PrEP Guidelines.

Who decided who participated in the study?

People participating in the EPIC-NSW study were assessed against the eligibility criteria by clinicians at participating sites across NSW and the ACT.

The PrEP ‘Program’

Going on PrEP isn’t just about taking a pill every day. It should be considered a health program taken in partnership with a clinician.

HIV Status

Firstly and most importantly, it is essential that you are tested for HIV prior to commencing PrEP. Starting PrEP when you are already HIV positive could lead to the virus becoming resistant to antiretroviral treatments, which may reduce your treatment options into the future.

When you have your HIV test, discuss with your clinician when your last potential exposure was so that you can both be confident that you are not in the window period (the time between when an infection occurs and it is detectable by an HIV test). Before commencing PrEP and during PrEP it is important to inform your team looking after you, if you have any symptoms which are consistent with HIV seroconversion such as sweats, fevers or other flu-like symptoms.

Working with a Clinician

Forming a good relationship with your clinician is one of the most important things that you can do for your health. When it comes to PrEP, you are potentially going to be having some detailed discussions about your sexual practices and other relevant issues such as alcohol and other drug use. All sites participating in the EPIC-NSW study are staffed by experienced clinicians and you should feel comfortable about having detailed discussions about your sexual practices with them.

Sexual Health Checks

As part of the PrEP program, regular check-ups for HIV and sexually transmissible infections (STIs) should be part of your routine. It is recommended that anyone taking PrEP has a full sexual health check every three months. If you are taking part in EPIC-NSW, you will need to see your clinician quarterly for comprehensive sexual health testing and new scripts for PrEP.

It is important to know if you have an STI and testing is the only way to be sure, as many STIs can have no symptoms. When left untreated, STIs can cause health complications and you may be passing them on to your sexual partners.

A sexual health check is easy. You should have STI tests of your urine, vagina, throat, anus and blood, including a test for HIV, for a complete sexual health check, depending on your sexual risk and sexual practices. Your clinician will advise you as to what specific testing regime is right for you. If you do get an STI, a clinician can assist you with contacting your previous sexual partners so that they can get tested as well.

EPIC-NSW Participating Clinics

Below is a list of sites who enrolled participants into the EPIC-NSW study.

NSW

ACT

EPIC-NSW Study Team

Protocol team

Study Sponsor
The Kirby Institute
Wallace Wurth Building
UNSW Sydney
Sydney NSW 2052
Australia

Protocol Co-Chairs
Prof David Cooper (deceased 18 March 2018), The Kirby Institute
Prof Andrew Grulich, The Kirby Institute

Co-Investigators
Prof Rebecca Guy, The Kirby Institute
A/Prof Iryna Zablotska, The Kirby Institute
Dr Jeff Jin, The Kirby Institute
Prof Janaki Amin, Macquarie University
Dr Nila Dharan, The Kirby Institute

Clinical Investigators
Dr Debbie Allen, Holden Street Clinic
Dr David Baker, East Sydney Doctors
Dr Mark Bloch, Holdsworth House
Clinical A/Prof Katherine Brown, Illawarra Shoalhaven (Wollongong) Sexual Health Clinic
Dr Christopher Carmody, Liverpool Sexual Health Centre
Prof Andrew Carr, St Vincent’s Hospital
Dr Kym Collins, Albury Sexual Health Service, Brookong Centre Sexual Health Service Wagga Wagga
Dr Robert Finlayson, Taylor Square Private Clinic
Dr Catriona Ooi, Clinic 16 (North Shore)
Dr Eva Jackson, Nepean Sexual Health Penrith, Blue Mountains Sexual Health Katoomba
Prof David Lewis, Western Sydney Sexual Health Centre
Dr Josephine Lusk, Short Street Clinic
A/Prof Anna McNulty, Sydney Sexual Health Centre, Orange Sexual Health Clinic, Dubbo Sexual Health
Prof David Templeton, Royal Prince Alfred Hospital
Dr Phillip Read, Kirketon Road Centre
Dr Nathan Ryder, Pacific Clinic (Newcastle)
Dr David Smith, Lismore Sexual Health Clinic
Dr Emanuel Vlahakis, Coffs Harbour Sexual Health, Port Macquarie Sexual Health
Prof Don Smith, The Albion Centre
Dr Nick Doong, Dr Doong’s Surgery
Dr David Townson, Macleay Street Medical Practice
A/Prof Bradley Forssman, Fountain Street General Practice
Dr Daniel Chanisheff, Green Square Health
Dr Gia Han Thai, Crown St Medical Centre
Dr Sarah Martin, Canberra Sexual Health Centre
Dr Tuck Meng Soo, Interchange General Practice
Dr Ben Anderson, St Leonards Medical Practice
Dr Richard Loizou, North Sydney Medical Centre and Skin Cancer Clinic
Dr James Koutsis, Potts Point Family Medical Practice

Associate Investigators
Ms Jo Holden, HIV and STI Branch, Centre for Population Health, NSW Ministry of Health
Dr Christine Selvey, Communicable Diseases Branch, Health Protection NSW
Dr Heather-Marie Schmidt, HIV and STI Branch, Centre for Population Health, NSW Ministry of Health
Dale Halliday, HIV and STI Branch, Centre for Population Health, NSW Ministry of Health
Mr Nic Parkhill, AIDS Council of New South Wales (ACON)
Mr Bill Whittaker, NSW Ministry of Health HIV Strategy Implementation Committee
Dr Kerry Chant, NSW Ministry of Health
Mr Craig Cooper, Positive Life NSW
Mr Scott McGill, Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine
A/Prof Catherine O’Connor
Dr Phillip Read, 
Kirketon Road Centre
Dr Rosalind Foster, 
Sydney Sexual Health Centre

Kirby Team
Ms Barbara Yeung, Senior Clinical Project Coordinator/Project Manager
Ms Gesalit Cabrera, Clinical Project Coordinator
Ms Erin Ogilvie, Clinical Project Coordinator/Data Manager
Mr Shawn Clackett, Research Assistant/Data Manager
Mr Mo Hammoud, System Manager
Ms Stefanie Vaccher, Behavioural Data Manager/Statistician/Epidemiologist
Ms Lucy Watchirs Smith/Dr Tobias Vickers, ACCESS Clinical Data Manager