EPIC-NSW stands for ‘Expanded PrEP Implementation in Communities in NSW’.
EPIC-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 estimates that there are around 3,700 eligible high-risk people in NSW. Further enrolment of high-risk people can occur. EPIC-NSW is a criteria-based access program – which means eligibility for the study will be determined on the basis of HIV risk criteria. The aim is to rapidly enrol eligible people and follow them for up to two years while they take PrEP.
Partners involved in the study include the Kirby Institute, UNSW (leading the study), NSW Health and Local Health Districts, ACON, Positive Life NSW, the Australasian Society for HIV 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 is based on the NSW PrEP Guidelines.
Who will decide who participates in the study?
People seeking to participate in the EPIC-NSW study will be assessed against the eligibility criteria by clinicians at participating sites across NSW.
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.
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.
To learn about joining the study, click here.