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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..

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

The PrEP BASICS

What is PrEP?
Pre-Exposure Prophylaxis is taking medicine before possible exposure to a virus or bacteria to prevent infection - in this case for HIV.  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 is a medication 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%. Truvada as PrEP 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?
PrEP is expensive - approximately $1000/mo. However, it is covered by some insurance plans. Because of the high cost, many people are looking for creative way to gain access.

To find out more re that go to:

  1. http://www.actoronto.org/PrEP/how (see the “Costs and Coverage” section)
  2. https://daviebuyersclub.wordpress.com (Canadian advice of buying generic “Truvada”) 

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

 

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?
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.

  

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. Truvada contains two medicines (tenofovir and emtricitabine) that are used 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?

Interim PrEP Guidelines for Nova Scotia: Formal Canadian guidelines for administering PrEP are still in development. Until they are available you can contact the Infectious Disease Clinic (902-473-6592) at the VG site for draft recommendations on assessing and administering PrEP in Nova Scotia.

Physician consults: In the absence of a formal Canadian (or Nova Scotian) protocol, Dr. Glenn Andrea (Halifax) and Dr. Tim Matheson (Bedford) are willing to consult for other practitioners re assessing and prescribing 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. 

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/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

 

 

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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