SUPPORT & EDUCATION FOR HIV, HEPATITIS & STIs

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PrEP

An Intro To PrEP for HIV Prevention

In February 2016, Health Canada approved the use of daily Truvada as PrEP (Pre-Exposure Prophylaxis) for reducing the risk of transmission of HIV. Many people have not yet heard of PrEP, or if they have are not sure what to make of it. As well, many healthcare providers are unsure of how to proceed when a patient asks them about it.

If you have any questions or concerns re PrEP that are not covered on this page, please contact the Gay Men’s Health Coordinator at This email address is being protected from spambots. You need JavaScript enabled to view it..

Also - check out the new video of the  "PrEP - The Pill to Prevent HIV: public information session" (scroll down to the bottom of this page) that took place on Jan. 31, 2018 at the Halifax Central Public Library. It was a great presentation and Q&A session with much valuable information shared.

So here’s some FAQs and resources to get started.

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What is PrEP?
Pre-Exposure Prophylaxis (PrEP) is taking medicine before possible exposure to a virus or bacteria to prevent infection - in this case for HIV.  The current option for HIV is two medications in one pill - sometimes referred to as oral PrEP because you take it orally. The brand name for this pill is Truvada, although there are now approved generic equivalents as well. However, PrEP is more than just taking pills, it also involves getting regular check-ups and tests done, to make sure everything is on track.

Is PrEP safe?
For most people, PrEP is very safe to take, and very easy on the system. Truvada (and it's approved generic equivalents) is a medication in pill form with a long and well-studied track record. It has been used to treat people who are HIV positive since 2004.

How effective is PrEP?
No HIV prevention tool is 100% effective. However, taken as directed, Truvada can reduce the risk of HIV infection by up to 99%.  Oral PrEP for HIV is already being credited with significantly bringing down HIV infection rates in high risk population in key centres in the US and the UK.

Is PrEP right for me?
Deciding whether or not PrEP is right for you starts with YOU. There can be side effects with taking any medication long term, so PrEP is only recommended for those who are at high risk of HIV.

How do I get PrEP?
PrEP requires a prescription from a doctor or nurse practitioner. There is typically an assessment process to determine if Truvada as PrEP is a good choice for you. Being on PrEP also requires some minor (but really important) regular follow up.

How much does PrEP cost?
Truvada is expensive - approximately $1000/mo, but the generic versions can be much cheaper ($250-$500 depending on brand and where bought). While PrEP is covered by some insurance plans, because of the high cost, many people are looking for creative ways to gain access.

To find out more re that go to:

  1. http://hivnow.ca/paying-for-prep/ (Ontario info but still can be helpful)
  2. https://daviebuyersclub.wordpress.com (Canadian advice of buying generic “Truvada” - scroll down to the heading "Introduction") 
  3. Generic PrEP has been cheaper in Toronto than anywhere else in the country so far, and The Village Pharmacy in Toronto will fill generic PrEP prescriptions from anywhere in Canada:
    • Call them (416-967-9221 or This email address is being protected from spambots. You need JavaScript enabled to view it.) to confirm process (in case of any changes);
    • Have doc fax or email prescription (to start process) - may need to follow-up with hard copy of script by mail;
    • provide insurance details for direct billing (where that applies), and/or arrange payment of premium or full price;
    • once paid for, the meds are shipped for free by courier.
    • They also have Android and Apple apps that can

Other Prevention Strategies?
PrEP is one way to prevent HIV from being passed during sex, but it’s definitely not the only way. PrEP is recommended in combination with other safer-sex strategies as an additional tool – not necessarily a replacement for other tools.  Not all prevention tools work for all people, but more options means more people are protected against HIV transmission. 

symbol online

http://www.catie.ca/en/prevention/statements/prep
CATIE Statement re HIV Prevention

http://www.catie.ca/en/prep
CATIE PrEP fact sheet

http://www.catie.ca/en/webinars/are-you-prepped-prep/resource-list
CATIE PrEP Resource list

http://www.actoronto.org/PrEP
ACT - includes a section on “Costs and Coverage” 

http://www.hivnow.ca/prep/
HIV NOW

http://www.getpreped.ca/
HIM- Get PrEPed

https://daviebuyersclub.wordpress.com
Davie Buyers Club (Canadian advice of buying generic)

https://www.facebook.com/groups/PrEPFacts
PrEPFacts Facebook Group 

https://www.cdc.gov/hiv/risk/prep/
US CDC

 

{slider I Don’t have a GP / My GP Doesn’t Know Enough About PrEP}

I Don’t have a GP. Where can I go to get PrEP?
Halifax Sexual Health Centre: The HSHC is also now doing assessments (and follow-up) for patients re PrEP. Anyone making an appointment with HSHC to access PrEP should clearly state so when they book their appointment. HSCH clients do not need a GP to access, or to follow up, PrEP at HSHC.

My GP Doesn’t Know Enough About PrEP. What Can I do?
If your doctor is new to PrEP for HIV they can get an overview of what is recommended by checking out the new Canadian PrEP protocol. Another option is physician consults: If you have a physician, your GP can refer you to other doctor’s for a consultation re PrEP. Dr. Glenn Andrea (Halifax) and Dr. Tim Matheson (Bedford) are willing to consult for other practitioners re assessing and prescribing PrEP at this time.

  

{slider Resources for Physicians and other Healthcare Providers}

Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV, but who are at substantial risk of getting it, to prevent HIV infection by taking Truvada or it's generic equivalents (the current approved oral PrEP) in pill form. This pill contains two medicines (tenofovir and emtricitabine). These medications already have a well documented track record (in combination with other medicines) to treat HIV. When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection. 

I don’t know enough about PrEP to assess my patient. What can I do?

PrEP Guidelines for Canada: For a long time there were no formal guidelines in Canada re prescribing PrEP (intially as an off-label option, and then more recenrtly once Health Canada approved Truvada in Feb. 2016 as oral PrEP for HIV). However, as of Nov. 27, 2017 the CMAJ Canadian guidelines regarding PrEP and non-occupational PEP for HIV were released. So now we do have well-researched and considered protocols for prescribing and follow up of oral PrEP for HIV.

Halifax Sexual Health Centre: The HSHC is also now doing assessments (and follow-up) for patients re PrEP. Anyone making an appointment with HSHC to access PrEP should clearly state so when they book their appointment. HSCH clients do not need a GP to access, or to follow up, PrEP at HSHC. 

symbol online

http://www.cmaj.ca/content/189/47/E1448 
CMAJ Canadian guidelines regarding PrEP and non-occupational PEP for HIV

http://www.catie.ca/en/prevention/statements/prep
CATIE Statement re HIV Prevention

http://www.catie.ca/en/prep
CATIE PrEP fact sheet

http://www.catie.ca/en/fact-sheets/co-formulations/truvada
CATIE Truvada fact sheet

http://www.catie.ca/en/webinars/are-you-prepped-prep/resource-list
CATIE PrEP Resource list

http://www.ctac.ca/our-issues/prep 
CTAC statement on the use of PrEP to prevent the sexual transmission of HIV

https://www.cdc.gov/hiv/risk/prep/
US CDC

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AUDIO: CBC Mainstreet interview promoting the Jan. 31st public info session on PrEP

ACNS's Prevention Coordinator Chris Aucoin and health research consultant San Patten are intereviewd.

VIDEO: PrEP - The Pill to Prevent HIV: public information session (Halifax, NS - 2018)

Join moderator Renée Masching, plus our panelists at the Paul O`Regan Hall of the Halifax Central Library. The event includes an introductory presentation, followed by an open Q&A taped on Jan. 31st, 2018.

The panel included: San Patten (Health Research Consultant); Dr. Matt Numer (Health Promotion Professor, Dalhousie University); Chris Aucoin (HIV Prevention Coordinator, AIDS Coalition of Nova Scotia); and Dr. Glenn Andrea (Medical Director, Dalhousie University Student Health & Wellness Centre).

This event was organized by the AIDS Coalition of Nova Scotia in partnership with the Nova Scotia PrEP Working Group, the Halifax Central Public Library, and the Nova Scotia Advisory Commission on AIDS. 

Media

VIDEO: PrEP - The Pill to Prevent HIV: public information session (Halifax, NS - 2018)

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PrEP: Just the Basics
Here is a video that is good as a quick int PrEP from Ontario’s Gay Men’s Sexual Health Alliance:  http://thesexyouwant.ca/prep/?v=prep

The Nova Scotia PrEP Working Group
At this time there is still uncertainty as to what extent public and private insurance plans cover PrEP in Nova Scotia, and a general lack of up-to-date information at all levels re PrEP.  The “ad hoc” Nova Scotia PrEP Working Group is strategizing about overcoming educational, financial and/or policy barriers re PrEP access in our province. If you are interested in finding out more about that, or in being involved in that work, contact San Patten at [email protected].

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