One‑stop digital hub for HIV prevention in rural Australia

In rural, regional and remote Australia, around two‑thirds of new HIV infections occur among gay, bisexual, queer and other men who have sex with men aged 18–25 (YGBQMSM). While this group represents a small and often invisible minority in many country towns, they are disproportionately affected by new HIV diagnoses.

A new study led by Charles Sturt University, funded by an NHMRC Ideas Grant, is working to change that by improving access to HIV pre‑exposure prophylaxis (PrEP) for young men outside the major cities.

PrEP is a highly effective HIV prevention medication. When taken as prescribed, it can reduce the risk of HIV transmission by up to 99 per cent. It is a cornerstone of Australia’s National HIV Strategy, which aims to end HIV transmission by 2030. Yet, YGBQMSM in non‑metropolitan areas face a very different reality to their peers in capital cities. They are more likely to have limited access to sexual health clinics and PrEP‑prescribing services, less likely to be connected to LGBTQIA+ communities and peer networks, and more likely to encounter stigma—both around sexuality and around HIV.

YGBQMSM and clinicians are thus adopting practical solutions with innovative approaches to change outcomes for rural LGBTQIA+ communities. A significant innovation will be a geo‑social mobile app tailored specifically to YGBQMSM in rural, regional and remote Australia, developed under the PrEP Empowerment Project.

The project, established in collaboration with rural communities and practitioners, is to better understand what helps and what hinders PrEP uptake among YGBQMSM in rural, regional and remote communities. A key strength of the project is its collaborative, community‑led approach, which recognises that local context matters: what works in inner‑city clinics does not necessarily translate to small towns where anonymity is limited and services are few.

Rather than simply being another health information website, the app is being designed as a one‑stop digital hub where users can access clear, evidence‑based information about sexual health and PrEP in the relevant language and find out where and how to obtain PrEP locally or via telehealth.

Importantly, the app will include a peer navigation component. Users will be able to connect with trained peer navigators—other young men with lived experience of using PrEP and navigating health services from outside metropolitan areas. These peers will offer guidance and support, answer questions about starting and maintaining PrEP, and help reduce the social isolation many young LGBTQIA+ people experience in smaller communities.

“Since the introduction of HIV PrEP, the HIV prevention landscape has fundamentally shifted. It is a great shame that not all LGBTQIA+ Australians have equal access to sexual health education and services to access HIV PrEP. For those living in regional and rural Australia, having a one-stop digital hub is a great stride forward in addressing health inequities,” said Bill Pitt (he/him), LGBTQIA+ community member.

For rural health professionals, the project will generate insights into current PrEP awareness and prescribing confidence, highlighting opportunities for targeted education and support. Strengthening the capacity of the rural primary care workforce to discuss sexual health openly and initiate PrEP where appropriate is essential if Australia is to meet its 2030 goal.

By bringing together young people, clinicians and researchers, and by integrating accurate information, service navigation and peer support into a single, co‑designed digital platform, the PrEP Empowerment Project aims to substantially increase PrEP uptake among YGBQMSM in non‑metropolitan Australia—preventing new HIV infections while fostering stronger connections and better sexual health outcomes for a group too often overlooked in rural health planning.

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