Melbourne

Australia / Victoria (state) / Melbourne

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.

Contraception

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/

What to Get & Where to Get It

While you may consult with many physicians for a birth control prescription, here are some recommendations:

• The Royal Women's Hospital: "The Women’s is Australia’s first and largest specialist hospital dedicated to improving the health of all women and newborns." Address: 20 Flemington Rd, Parkville, Victoria. Main Reception Phone: (03) 8345 2000.
• Family Planning Victoria: Address: 901 Whitehorse Rd, Box Hill VIC 3128, Australia. Hours: Open today · 9AM–5PM. Phone: +61 3 9257 0100
• Fertility Control Clinic: Expensive if you're uninsured but quality care. Address: 118 Wellington Parade, East Melbourne VIC 3002, Australia. Phone: +61 3 9419 2922. Hours: Open today · 7:30AM–5PM
• Melbourne Sexual Health Centre: "Specializes in the testing, treatment and management of sexually transmissible infections. Also offers Pap smears, contraception, and related services." Address: 580 Swanston St, Carlton VIC 3053, Australia. Hours: Open 12:30–5PM. Phone: +61 3 9341 6200
• St. Kilda Super Clinic: Address: 1/158 Acland St, St Kilda VIC 3182, Australia. Phone: +61 3 9525 5766

You can also get a birth control prescription and order contraceptives online at:

• Doctos - a legitimate company that offers Depo-Provera, Nuvaring and oral contraceptives such as Levlen, Estelle 35, Yasmin, Yaz, Microgynon, etc.
• The Chemist Warehouse: We don't know much about this company but they sell oral contraceptives (Levlen, Trifeme, Microlut, Monofeme, Nordette, Microgynon) and IUDs (Mirena). They claim to be "Australia's #1 Online Pharmacy" and have free shipping for orders over $99.

As for 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?"

Costs

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

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

Important Notes: The earlier you take emergency contraception, the more effectively it works. After unprotected sex, take EC as soon as possible. If you don't have access to EC, you can use oral contraceptives as EC, but remember the following: 1) Only some contraceptives work as EC (so confirm they work as EC) 2) Different contraceptives require different dosages to work as EC (so get the proper instructions) 3) You must only use the first 21 pills in 28-day packs and 4) You must also take the pills as soon as possible.

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.

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 Note: 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 that may prevent HIV infection, and it may be available in your city (see below for details).

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. However, here's a list of some places to consider:

• 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

• 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.
• 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. "
• Fertility Control Clinic: "Our Clinic is the first and longest running clinic of its kind in Australia. We offer many years of experience and expertise that enables us to provide women with the best possible service, attention and support."
• Yarra Medical Richmond: You can make an appointment online. 486 Victoria Street Richmond VIC 3121. 03 9428 6200.
• 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."

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

Medications & Vaccines

What to Get & Where to Get It

For yeast infections, you should be able to buy Canesten in Melbourne 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

Gynecological Exams

Pregnancy

Abortion

Laws & Social Stigmas

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.

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

• 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
• 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
• Women's Clinic: Offers medical or surgical abortions in East and West Melbourne. Abortion is $300 with Medicare Card. Call (03) 9769 4134 or go online to book an appointment.
• Hampton Park Women's Health Care: Assists women in 5-13 weeks of pregnancy. "Hampton Park Women’s Health Care recognises how difficult and sensitive the issue of an unplanned pregnancy can be. Having worked in this field of health care for many years our female Doctor has established this clinic with one important goal in mind – to make your experience one in which you feel calm, informed, dignified and safe." Address: 4 Warana Drive, Hampton Park. Phone: 03 9799 2817. Email: office@hpwh.com.au
• Royal Women's Hospital: "The Women’s provides a very limited number of appointments for abortions. Priority access for abortions is given to women with a health care card. You will need to speak with a member of the Women’s Pregnancy Advisory Service to find out whether you can access any available appointments."
• 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)

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