Melbourne: Difference between revisions

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'''OVERVIEW'''

In Melbourne, you can find an incredible amount of health care resources, many of which are progressive and LGBT-friendly. While you'll need a prescription for contraception, the prescription process is rather straight-forward, and you may even be able to get a prescription online. As for emergency contraception, it's fully legal for all ages and no prescription is required. There is access to both PrEP and PEP, and many health centers, both large and small, provide STI/STD testing. Regarding abortions, Melbourne is under Victoria state law, which is one of the most open in the world. You can get an abortion for up to 24 weeks of pregnancy, and if two physicians recommend it, you can even get an abortion after that time.  

'''General Note:''' There are many types of contraceptives, including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click [https://www.plannedparenthood.org/learn/birth-control here].

[[File:Levlen australia.jpg|300px | thumb|left|frame|'''Levlen ED birth control pills purchased in Australia''']]

In Australia, you will need a prescription from a physician to obtain birth control. However, these consultations are pretty straight-forward and do not typically require pelvic exams. There is an incredibly wide range of contraceptives offered, from hormonal pills to injectables and IUDs, and practically every known contraceptive is available in Australia. It is estimated that 67%-70% of Australian women of fertility age (who are married or in unions) use some form of contraception,<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide, 2015]</ref> without about 24% of Australian women on oral contraceptives.

Note: Australian women who believe they may have been adversely affected by Yaz or Yasmin can register for a potential class action suite: http://tgb.com.au/enquire/class-action/

[[File:Femme ed australia.jpg|200px | thumb|right|frame|'''Femme-Tab ED birth control pills purchased in Australia''']]

* For a full list of contraceptive options available in Australia, click [http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=AU here].

* If you want '''condoms''', they're easy to purchase at supermarkets, chemists/pharmacies, convenience stores and petrol stations. If you're looking for free condoms, check out Frontyard Youth Service, which is at 19 King Street (near Flinders Lane). Phone: 03 9611 2411 or Freecall: 1800 800 531. There's also [http://www.redaware.org.au/sexual-health-information/ Red Aware]: "If you live in Australia, you can receive a free safe sex kit with condoms tin, and awesome safe sex ... Would you like to sign up to receive a free RedAware safe sex kit?"

* If you want a '''contraceptive shot/injectable''', you can find Depo-Provera and Depo-Ralovera in Australia.<ref>[http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=AU IPFF Australia]</ref>

Generally, you'll pay $3-6 for a month supply of birth control pills.

One Australian wrote, "I am from Queensland (Gold Coast) and have Medicare so costs might be a bit different. Levlen cost $10-12 ish (for a box of 4 x 28 pills). The Implanon (without Medicare) was about $200 and with Medicare about $30 plus I had to go to a clinic to have a doctor put it in. Average cost of doctor's visit in Australia (without Medicare) is $60-80."

For condoms, if you're a young person, you should look into the Condom Credit Card, which is "a friendly, confidential way for young people to get FREE condoms! Simply go to a Family Planning NSW clinic or a service that displays the CCCard posters and ask for your own CCCard. Then you can to receive free condoms every time you present your CCCard at a registered provider." For more information about the Condom Credit Card, visit the [https://www.fpnsw.org.au/media-news/news-events/health-promotion-projects/condom-credit-card-project NSW website] or the [http://www.bettertoknow.org.au/AMS Aboriginal Medical Services website].

'''Important Tip''': If you qualify, you may want to get a Medicare Card and look into Bulk Billing, which is a payment option under Australia's Medicare system. When the health service provider (e.g. doctor) bills the government (via the patient's Medicare card), the provider is paid 85% of the scheduled fee for outpatient services and 75% of the scheduled fee for inpatient services by the government. This allows the service provider to receive a fixed proportion of the scheduled fee and avoid debt collection. And, as a patient, this means you may not be charged anything.

'''Important Notes:''' Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC '''as soon as possible''' after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click [https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception here] and [http://ec.princeton.edu/info/ecp.html here].

Emergency contraception is legal and obtainable without a prescription. There are no age restrictions and anyone, no matter their sex, can buy them. EC brands like Plan B or Next Choice can be found in public sector clinics, pharmacies and emergency rooms. The law requires that pharmacists supply EC for therapeutic reasons. This means that, if a pharmacists wants to confirm therapeutic need, he or she may ask questions about your medical history, medical issues and any medications that you're currently taking before issuing EC.  

According to the International Consortium for Emergency Contraception, "While community pharmacists are not required by law to ask specific questions prior to supplying LNG-EC in Australia, questioning may occur in practice. The Pharmaceutical Society of Australia supports increased access for young women with no specific restrictions on third party supply and advanced supply. Access can be limited in rural areas if the only pharmacist in town has a conscientious objection to supplying the LNG-ECP and there is no alternative supplier nearby. There are no legal age restrictions for supplying ECPs, but many pharmacists may prefer to refer women under 16 years of age to a doctor rather than provide it themselves over the counter."<ref>[http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/australia/ Australia: EC Status and Availability]</ref>

There are strict guidelines in Australia, dictated by the Pharmaceutical Society of Australia, regarding how EC should be sold by local chemists. While most pharmacists/chemists follow these guidelines, studies showed that "pharmacists had stronger, more conservative attitudes than overseas pharmacists"<ref>[http://www.ncbi.nlm.nih.gov/pubmed/21237342 Provision of the emergency contraceptive pill without prescription: attitudes and practices of pharmacists in Australia]</ref> and "22% of pharmacists felt it was reasonable for their religious faith to influence supply."<ref>[https://theconversation.com/note-to-pharmacists-on-how-not-to-sell-the-morning-after-pill-10250 Note to pharmacists on how not to sell the morning-after pill]</ref> Furthermore, many Australian women report that they don't receive adequate information from pharmacists. As reported by the Conversation in 2015, "...62% of the women we spoke to expressed concern about the lack of privacy. What’s more, many women were confused about this type of pill – some thought it caused an abortion (32%) and others that it would cause defects if they were to fall pregnant later (61%). Only 20% of pharmacists always informed women about how the emergency contraceptive pill worked, while the majority spoke about how long it would remain effective after unprotected sex. Many pharmacists agreed that the pill shouldn’t be supplied if unprotected sex had occurred longer than three days ago."<ref>[https://theconversation.com/note-to-pharmacists-on-how-not-to-sell-the-morning-after-pill-10250 Note to pharmacists on how not to sell the morning-after pill]</ref>

'''Note''': You can now buy ellaOne in Australia, which is an emergency contraceptive that is effective for up to five days after unprotected sex. Of course, take EC as soon as possible -- but, if it has been a few days since you had unprotected sex, try to find ellaOne. If you can't access ellaOne, copper IUDs may also prevent pregnancy up to 5 days after unprotected sex. If none of these options are available, and it's been over 3 days since you had unprotected sex, you can still take EC, which may work up to 5 days. Note that EC pills are not 100% effective and should be taken as soon as possible.

For dedicated EC, progestin-only, there are Levonelle-1, Norlevo-1 and Postinor 1 (take 1 pill within 120 hours after unprotected sex). There are also Levonelle-2 and Postinor-2 (take 2 pills within 120 hours after unprotected sex). If you cannot access dedicated EC, you may use some oral contraceptives as EC. They are Microlut (take 50 pills within 120 hours after unprotected sex), Levlen ED, Microgynon 30 ED, Monofeme 28, Nordette 28 (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later), or Loette, Microgynon 20 ED or Microlevlen ED (take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later).<ref>[http://ec.princeton.edu/ Princeton Emergency Contraception Website]</ref>

As reported by the Conversation: "If a woman had unprotected sex outside of this timeframe, a pharmacist can still supply the emergency contraceptive pill. This supply is called 'off label' as it is outside of the TGA-licensed use. In such cases, pharmacists should inform women about the effectiveness of this emergency contraception beyond three days and document that they supplied it. (Or they could recommend the woman have an intrauterine device (IUD) placed instead. This IUD is the most effective form of emergency contraception and can be inserted up to five days after unprotected sex.)"<ref>[https://theconversation.com/note-to-pharmacists-on-how-not-to-sell-the-morning-after-pill-10250 Note to pharmacists on how not to sell the morning-after pill]</ref>

EC should cost between 20-50 AUSD.

'''Important Notes - Learn about PEP and PrEP:''' If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click [https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/post-exposure-prophylaxis/ here]. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click [http://www.whatisprep.org/ here].

If you are applying for permanent Australian visa, you will be required to take an HIV test. If you are found to be HIV+, this will not automatically disqualify you but it will be included in the criteria used to assess your application.<ref>[HIV Travel: Australia]</ref>

[http://getpep.info/ PEP Hotline, Victoria]: 1800 889 887. "Phoneline is staffed 24 hours a day Friday to Monday, and 8:30am to midnight, Tuesday to Thursday. Other times there is a detailed recorded message with many options."

You can get STI/STD tests from most doctors, family planning clinics or sexual healths clinics. However, here's a list of some places to consider:

* [http://www.checkyourrisk.org.au/ Check Your Risk] - This is NOT a replacement for an STI/STD test. But it is a resource, based out of Australia, that helps you assess your risk

* [http://www.mshc.org.au/ Melbourne Sexual Health Centre]: Opening Mon - Thur: 8.30am - 5.00pm, Fri: 12.30pm - 5.00pm. Or by Appointment Only Thur Evening Clinic: 5.00 -7.00pm� Ph: 03 9341 6200. Address: 580 Swanston Street, Carlton, 3053 Vic.

* [http://www.testme.org.au/ TestMe]: "TESTme is a free service of Melbourne Sexual Health Centre (MSHC) for rural Victorians aged 25 years and younger, rural Victorian men who have sex with men and Aboriginal and Torres Strait Islander people. "

* [https://www.smarthealth.me/ SmartHealth]: "Australia’s Intelligent STI/STD Check. Fast, Convenient and Discreet. No Doctor Required. Results by SMS within 48 Hours. Over 1,450 Pathology Collection Centres Throughout Australia."

* [http://www.ahmf.com.au Australian Herpes Management Forum]

* [https://www.afao.org.au/ Australian Federation of AIDS Organisations]

* [https://www.hepvic.org.au/ Hepatitis Victoria]

For yeast infections, you should be able to buy Canesten in Melbourne pharmacies or online at [http://www.chemistwarehouse.com.au/Shop-Online/1402/Thrush-Treatments Chemist Warehouse]. Regarding the HPV vaccine, Australia is incredibly proactive and has vaccination programs in place for both girls and boys. For more info on Australia's HPV vaccination program, check out [http://www.australia.gov.au/hpv this link]. For most STI/STD medications, you will need to first visit a physician for a prescription, which you can then usually fill at hospitals or pharmacies.  

Regarding PrEP: "There are three ongoing demonstration projects in Australia—VicPrEP in MSM, transgender women, heterosexual serodiscordant couples and people who received N-PEP on more than two occasions; PRELUDE in men and women at high and ongoing risk of HIV; and EPIC-NSW enrolling high-risk, mostly gay and bisexual men in New South Wales. A fourth demonstration project, PrEPX, will start later this year. The Therapeutic Goods Administration has approved daily oral Truvada for HIV prevention."<ref>[http://www.prepwatch.org/australia/ PrEP Watch: Australia]</ref>

[[File:Divacup.jpg|300px | thumb|right|frame|'''DivaCup, one of the menstrual cups available in Australia''']]

'''Note:''' In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click [https://en.wikipedia.org/wiki/Menstrual_cup here]. To learn more about menstrual underwear, click [http://menstrualcupreviews.net/best-period-panties-reviews/ here].

Pads and tampons (without applicators) are very easy to find. Aside from being sold in supermarkets, pharmacies and convenience stores, you can also find them in many bathrooms. You can find tampons with applicators (usually cardboard), like Tampax or Kotex, in major supermarkets and shopping malls. As for menstrual cups, there is one Australian distributor of DivaCup: [http://www.bartonbrands.com.au Barton Brands], Represented By: Lightning Brokers: PO Box 1218, Springwood, Qld 4127, 1-300-884-456, info@biosports.com.au. As for MoonCup, there are no distributors in Australia, it seems, so it should be bought online. As for LadyCup, there are no distributors in Australia, so it's best to buy online or purchase online from an NZ distributor, like Tweedle or Mother's Instinct.

'''Important Note:''' There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click [https://www.plannedparenthood.org/learn/abortion here].

In Australia, abortion laws are determined by state. In Victoria, abortion is permitted for up to 24 weeks of pregnancy. After 24 weeks, it is legal if two physicians agree that it is appropriate. All standard reasons for an abortion are permitted, including: to save the life of the woman, to preserve physical health, to preserve mental health, rape or incest, fetal impairment, economic or social reasons, and available on request. Furthermore, Mifepristone (the abortion pill) was registered in 2012. The abortion laws in Victoria have been in place since the Abortion Law Reform Act (2008). Before that time, the Victorian Crimes Act, abortions were only permitted if the pregnancy threatened the life of health of the woman.<ref>[https://en.wikipedia.org/wiki/Abortion_Law_Reform_Act_2008_(Victoria) Abortion Law Reform Act 2008 (Victoria)]</ref>

Regarding MIsoprostol availabilty, Women on Waves reports that "Misoprostol is available as cytotec. We do not have any information how easy it is to get in a phamacy.  In 2012, mifepristone and misoprostol were approved for use in termination of pregnancy by our Therapeutic Goods Administration (http://www.tga.gov.au/hp/information-medicines-mifepristone-gymiso.htm). They are only available through medical practitioners, and cannot be purchased over the counter in pharmacies without a prescription. In practice, access will be difficult for women who don’t live geographically near a clinic or practitioner who provides this service (a similar problem for surgical abortion in Australia)."<ref>[https://www.womenonwaves.org/en/page/4970/australia--organizations-and-clinics Australia: Organizations and clinics, Women on Waves]</ref>

Abortion facilities are also protected. It is illegal to protect within 150 meters of an abortion service.<ref>[http://childrenbychoice.org.au/factsandfigures/australianabortionlawandpractice Australian Abortion Law and Practice]</ref>

While you consult with your GP for abortion service referrals, here's a list of some places to consider:

* Misoprostol is available as Cytotec along with Mifepristone. Women can get access to a medical abortion through a phone service telephone number: 1800 180 880.  

* [http://www.mshealth.com.au/ MS Health]: Has the abortion pill. "MS Health is a not-for-profit pharmaceutical company established to deliver vital reproductive health products and medicines. We are proud  to be part of Marie Stopes International, delivering a global mission of children by choice, not chance."

* [http://www.fcc.com.au/ Fertility Control Clinic]: "The Fertility Control Clinic is Australia's first private abortion clinic established to provide women with access to high quality and safe termination of pregnancy and contraception. The clinic was established in 1972 and has been caring for women for over forty years. Today the Fertility Control Clinic is the leading private provider of pregnancy termination, family planning and reproductive health." Address: 118 Wellington Parade, East Melbourne, Victoria. Phone: (03) 9419 2922. Email: clinic@fcc.com.au

* [https://www.drmarie.org.au/ Marie Stopes Facility] - Locations in East Melbourne & East St. Kilda. "Our services provide women with a supportive, compassionate and confidential environment in which to discuss and assess the available options. We assist you in deciding what the right procedure is for you, depending on your preference and the stage of the pregnancy. All patients (Medicare and non-Medicare) undergoing a termination of pregnancy procedure at a Dr Marie clinic are eligible for a free STI check for Chlamydia and any other STI deemed appropriate by assessment, or at your request." Note that Marie Stopes facilities in Australia are called Dr. Marie. Address 1: East Melbourne, Suite 4, Level 1, 182 Victoria Parade, East Melbourne VIC 3002, Call 1300 405 568. Address 2: East St. Kilda, 338 Dandenong Rd, Phone: +61 1300 003 707

* [http://http://www.monashhealth.org/ Monash Health]: "Our specialties include paediatrics (caring for children), cardiology (caring for the heart), womens health, kidney and pancreas transplants and intensive care for sick and preterm babies in the first few weeks and months of life." Phone: 1300 3 iCARE (1300 342 273)

Abortion services range from $300 to $500. If you do not have a Medicare card, you may have to pay a higher rate.

* If you're in immediate danger, dial 000

* 1800 RESPECT or 1800 737 732: The National Sexual Assault, Family & Domestic Violence Counselling Line is a free telephone and online confidential service for any Australian experiencing or who has experienced domestic or family violence and/or sexual assault. It is available 24 hours a day, 7 days a week.  

* [http://www.wdvcs.org.au/ Women’s Domestic Violence Crisis Service]: 1800 015 188 or 03 9322 3555

* 24 hour hotline that connects you with nurses & provides health advice for all Victorians: Call 1300 60 60 24

* Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619

* Warrnambool Community Health Care – Sexual Health Tel. (03) 5563 1666

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