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Most patients do not pay anything out of pocket for PrEP with us.
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Since 2019, we have helped with the care of over 2,000 Ontarians.
All About PrEP
PrEP stands for pre-exposure prophylaxis and is a prescription medication typically taken daily to reduce the risk of acquiring HIV. If taken consistently, it can reduce the risk from condomless sex by up to 99%. It can also reduce the risk in people who inject drugs.
Answers for Everything PrEP
Health is very personal and we feel it’s important to provide information to help you make a well-informed decision about PrEP. It may not be for everyone but it is an important and highly effective HIV prevention option to consider. Take control of your sexual health!
PrEP is a combination of two drugs that fight against HIV known as “antiretrovirals”. They work by preventing HIV from being able to take hold in the body. The medications in PrEP are actually sometimes used as part of HIV treatment regimens as well (but can’t be used alone in treatment, only for prevention).
According to the manufacturer one tablet should be taken every day. Studies have found medication effectiveness depends on how regularly it is taken. Missing doses will make it less effective.
Individuals on daily PrEP will have maximum protection from front or vaginal sex at 21 days and anal sex at 7 days. The medication needs to be continued once daily as consistency determines the level of effectiveness.
There is also another way people take PrEP called On-Demand PrEP. Learn more about it here!
If you have unprotected sex and don’t always know your partner’s status, PrEP may be right for you. 1 in 7 people living with HIV do not know they have the virus. HIV does not discriminate if you have sex once or several times.
Take control and consider PrEP if any of the following apply to you:
- You don’t always use condoms (external or internal) when you have anal or vaginal intercourse and aren’t certain of your partner’s HIV status (or plan to)
- You’ve been diagnosed with a sexually transmitted infection in the last six months
- You’re in a relationship with a partner living with HIV, but they are not undetectable
- You are a person who injects drugs, or you’re in a sexual relationship with a person who injects drugs
- You have accessed emergency PEP (post-exposure prophylaxis)
PrEP is generally well tolerated and side effects can include stomach upset, headache, or feeling tired. These symptoms usually improve or go away with use. The medications in PrEP have now been studied and taken for 20 years.
Rare potential side effects include impact on your kidney function but your prescriber will monitor this during regular bloodwork. Any changes are generally reversible upon stopping the medication. The other possible side effect is changes in bone mineral density (bone strength). This is generally minor and reversible upon discontinuation.
There is a newer version of PrEP that can further reduce this rare risk – learn more about different PrEP options here.
Learn about what’s safe to take with PrEP here.
PrEP requires a prescription and monitoring. The PrEP Clinic connects you with free online prescribers if you do not have a family doctor, your doctor will not prescribe it, or you are seeking additional discretion. As you require regular monitoring and follow-up on PrEP, many walk-in clinics will not prescribe it.
The prescriber will discuss with you if PrEP is right for you and order lab work. This includes testing for sexually transmitted infections (STIs), including HIV. They can then prescribe the medication and you will get lab work again before your next prescription refill.
An individual will need to test HIV-negative to be on PrEP. Taking PrEP as prescribed reduces the risk by up to 99% and acquiring HIV on PrEP is extremely rare.
If you aren’t ready for an appointment but have questions you can call, text, or email us 7 days a week! Our team is made up of regulated healthcare professionals who are always available and have the training and knowledge to answer all your questions.
PrEP is currently covered for many by the public Ontario Drug Benefit Program (ODB) and through private plans. For anyone new to PrEP without coverage the first 3 months are free through the PrEPStart program.
The following people automatically have PrEP fully covered through public programs:
- For anyone under 25 with an Ontario health card and no private insurance (OHIP+)
- Seniors over 65 with an Ontario health card
- If you are on ODSP (Ontario Disability Support Program) or OW (Ontario Works)
- If you are First Nations or Inuit and have coverage through NHIB
In addition, most workplace and school insurance plans provide some coverage for PrEP. Some plans require a special authorization form which we can assist with.
If you are without coverage or need additional support, the Ontario government has a free program called Trillium that anyone with an Ontario health card can apply to and helps with medication costs. https://www.ontario.ca/page/get-coverage-prescription-drugs
If you are ineligible for any coverage options or just have partial coverage we can connect you with PrEPSaver. Through this most patient do not pay anything out of pocket for their PrEP with The PrEP Clinic. This is ongoing and not just limited to a few months. Learn more here
Before you start PrEP the clinic will order lab work. We can send these requests to a local lab in your community anywhere in the province (eg. LifeLabs, Dynacare) for you to complete. If you are near our in-person Toronto or Ottawa clinics you are also welcome to get them done on-site with us.
Sexual health tests include: HIV, syphilis, gonorrhea, chlamydia, Hepatitis A, B, and C.
General tests include: creatinine/eGFR (kidney function test), complete blood count, and urinalysis, pregnancy (if applicable)
Lab tests will include blood work, urine collection, and swabs. We have had several patients who switched to our care that were not being offered swabs by their previous care provider. Learn why these are SUPER important here. A person will get lab testing every 3 months when they are on PrEP. If you have been sexually active just before your initial testing, your care provider may order repeat testing in the first 30 days of starting too.
Learn more about these tests on our Get Tested page.
Myths About PrEP
There’s a lot of misinformation out there. We’re a fact and evidence-based zone.
Myth 1: PrEP encourages everyone to higher risk behavior and increases STIs.
FALSE. Earlier studies that looked at PrEP use had found that PrEP did not significantly change sexual behavior. People who were already at risk just got protection. They also were tested more frequently due to regular monitoring being on PrEP. Some newer studies have suggested a potential increase for some.
Myth 3: People who are more sexually active go on PrEP.
FALSE. Besides the fact we should not be disparaging people who have more sex, HIV does not discriminate whether someone has sex once or multiple times. Each sexual interaction is its own independent risk.
Myth 2: PrEP is effective so condoms are not needed anymore.
Condom use should still be considered as PrEP does not protect against other STIs besides HIV. PrEP plus condom use does further reduce the risk but is something for each person to determine what is right for themselves.
FALSE. It’s always important to check with a pharmacist to see if there are any drug interactions or protentional interactions. An example, is anti-inflammatory medications like Advil (ibuprofen). Regular use of these medications while on PrEP may further increase the risk of the rare side effect affecting the kidneys. Hormone medications that may be taken by some transgender individuals can generally be combined safely with PrEP. Learn more on our Drug Interactions page.
Learn even more about PrEP
Go swab yourself.
Swab tests are essential while on PrEP. Learn about these important tests and how you can get them done through us.
Incidence of Gonorrhea and Chlamydia Following Human Immunodeficiency Virus Preexposure Prophylaxis Among Men Who Have Sex With Men: A Modeling Study. SM Jenness, et al. Clinical Infectious Diseases, Volume 65, Issue 5, 1 September 2017, Pages 712–718.
AY Liu, et al. Sexual risk behavior among HIV-uninfected men who have sex with men participating in a tenofovir preexposure prophylaxis randomized trial in the United States. J Acquir Immune Defic Syndr. 2013 Sep 1;64(1):87-94.
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