Australia

OVERVIEW

In Australia, 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, laws vary from province to province. For example, in Victoria, 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. However, this is not the case in other provinces.

Contraception (Birth Control)

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 here.

Laws & Social Stigmas

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, 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/

The law for abortion in Australia is different in all states and territories. An infographic map of the laws by Reproductive Choice Australia (with hyperlinks to the actual legislation) can be found here: https://d3n8a8pro7vhmx.cloudfront.net/reproductivechoiceaustralia/pages/89/attachments/original/1501309922/AbortionLawSummaryWithMap_August2017.pdf?1501309922

What to Get & Where to Get It

• For a full list of contraceptive options available in Australia, click 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 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're interested in birth control pills, you will need to consult with a physicians for a prescription. Once you have a prescription, you'll find a wide variety of birth control pills available in Australia with over 30 brands registered in Australia.
• As for IUDs, you can get them from ob/gyns. One female traveler wrote about the Mirena that they got in Australia: "It lasts up to 5 years, needs to be fitted by an OBGYN (some charge to put it in, some don't), costs about $40 to buy the IUD if you have a Medicare card and about $245 if you don't."
• If you want a contraceptive implant, you can find Implanon in Australia.
• If you want a contraceptive shot/injectable, you can find Depo-Provera and Depo-Ralovera in Australia.

Costs

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 NSW website or the 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.

Emergency Contraception (Morning After Pill)

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 here and here.

Laws & Social Stigmas

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."

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" and "22% of pharmacists felt it was reasonable for their religious faith to influence supply." 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."

What to Get & Where to Get It

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).

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.)"

Costs

EC should cost between 20-50 AUSD.

Sexually Transmitted Infections (STIs/STDs)

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 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 here.

HIV self-administered test kits (home HIV test kits) are not sold in individual pharmacies although the kit was actually introduced in Australia in 2014 following the government lifting restrictions of self-testing, direct to consumer kits. But these kits have not yet been approved by the TgA (The Therapeutic Goods Administration which falls under the Department of Health in Australia). Hence, because they have not yet been regulated or approved by the TGA they are currently not legally allowed to be sold or exported. When it comes HIV testing in Australia, the choice is between Rapid HIV testing, which has TGA approval, but is limited to clinical situations and must be carried out by appropriately trained workers and laboratory based tests, which involve a medical blood draw and laboratory analysis of the sample.

Laws & Social Stigmas

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.

What to Get & Where to Get It

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."

Testing Facilities

• You can get STI/STD tests from most doctors, family planning clinics or sexual healths clinics. Check out the city pages, such as Melbourne for specific sites. For HIV, you can be assessed for PeP (Post Exposure Prophylaxis) at sexual health clinics, doctors (including some general practitioners) who specialise in HIV/AIDS, and hospital accident and emergency departments (which are open 24 hours). There are sexual health (MSHC) centres which are walk-in clinics providing testing and treatment for sexually transmissible infections. For people with a relevant visa, that have applied for permanent residency or are a visitor from a reciprocal health care agreement country, treatment is given for free, if they hold a Medicare card.

Drugs for PrEP (Preexposure prophylaxis) are available but these are extremely expensive and require a medical prescription. You can order the drug online as importation is permitted under the Personal Importation Scheme Rules set by the Therapeutic Goods Administration. Only a three month supply for personal use is permitted.

• 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

There are companies, for example INSTI®, that provide rapid HIV screening testing kits online anywhere in Australia but, in the case of INSTI® the company is Canadian and based in Canada. Positive HIV screening results will require further testing by a laboratory/clinic which can actually diagnose the disease.

Support

• Australian Herpes Management Forum
• Australian Federation of AIDS Organisations
• National Association of People Living with HIV Australia
• Australian Management Guidelines of Syphilis
• Hepatitis Australia: They have a national information hotline (1-800-437-222)
• Hepatitis Victoria
• Laws and Info for HIV home kits

Medications & Vaccines

What to Get & Where to Get It

For yeast infections, you should be able to buy Canesten in Australia pharmacies or online at 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 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."

Menstruation

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 here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

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: 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.

Abortion

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 here.

Laws & Social Stigmas

In Australia, abortion laws are determined by state or territory. An infographic of all state and territory laws can be found here: https://d3n8a8pro7vhmx.cloudfront.net/reproductivechoiceaustralia/pages/89/attachments/original/1501309922/AbortionLawSummaryWithMap_August2017.pdf?1501309922

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.

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)."

Abortion facilities are also protected. It is illegal to protect within 150 meters of an abortion service.

What to Get & Where to Get It

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

Medical Abortion ("the abortion pill") Providers

• 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.
• 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."

Clinics & Hospitals Offering Abortion Services

Visit the city pages for recommended hospitals and clinics.

Queensland based organisation, Children by Choice, maintains a list of larger providers on their website. Queensland services here: https://www.childrenbychoice.org.au/forwomen/abortion/clinicsqld Other states and territories here: https://www.childrenbychoice.org.au/forwomen/abortion/clinicsinterstate

Please note that General Practitioners can provide medical terminations in primary care practices and community health centres, however often don't want to advertise this for fear of anti-choice picketers or other activities. Check with the Family Planning organisation in the state or territory you are in to find your closest provider.

Costs

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

Advocacy & Counseling

What to Get & Where to Get It

• 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.
• Women’s Domestic Violence Crisis Service: 1800 015 188 or 03 9322 3555

List of Additional Resources

• 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
• YAK: "At our youth Action Centre, we run YAK, a social support group for same-sex attracted young people. Some group members identify as gay, lesbian, bisexual or queer and some are unsure of their sexual identity or don't want to label themselves."
• Victorian AIDS Council/Gay Men's Health Centre Tel. (03) 9865 6700 or 1800 134 840
• Education and Resource Centre, Alfred Health Tel. (03) 9076 6993
• The Centre Clinic, St Kilda Tel. (03) 9525 5866
• Family Planning Victoria Tel. (03) 9257 0100 or 1800 013 952
• Action Centre (for young people 25 years and under) Tel. (03) 9660 4700 or 1800 013 952
• PEP Information Line Tel. 1800 889 887
• Ballarat Sexual Health Clinic Tel. (03) 5338 4500
• Bendigo Community Health Tel. (03) 5434 4330
• Geelong Sexual Health Tel. (03) 5202 9333
• Wodonga Clinic 35 Tel. (02) 6022 8888
• Traralgon AIDS/STD Clinic Tel. (03) 5173 8111
• Warrnambool Community Health Care – Sexual Health Tel. (03) 5563 1666