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Pre-Exposure Prophylaxis (PrEP)

Pre-exposure prophylaxis (PrEP) involves the use of a daily oral HIV medication (called antiretrovirals or HAART) by people who are HIV-negative to prevent HIV infection.

PrEP is different from PEP (post-exposure prophylaxis), as PrEP is taken before exposure to HIV and may be taken on a long-term basis.

How does it work?

PrEP usually comes as a combination tablet that contains two medications called tenofovir and emtricitabine (under the brand name Truvada®). It can be taken every day (called daily dosing) or around the time of sexual activity (called intermittent dosing). Daily dosing is recommended for PrEP, as it has been the most widely evaluated in research studies.

A number of studies have looked at the use of PrEP to see if it is effective in lowering the risk of HIV infection. Research has shown that when PrEP is used properly, it is more than 90% effective in preventing HIV.

Cost

As of January 1, 2018, PrEP is covered at no cost (free) by BC health insurance (also called BC MSP, BC Carecard, BC Services Card) for people who are at high risk of HIV infection. This includes men and transwomen who have sex with men, people who inject drugs, and people who have sex with individuals living with HIV. PrEP is available through the HIV Drug Treatment program at the BC Centre for Excellence in HIV/AIDS

For any First Nations people in BC who previously had PrEP covered through the First Nations Health Authority, coverage is now only available through the HIV Drug Treatment program.

PrEP is also available free-of-charge for all Inuit people in British Columbia who are receiving benefits through the Non-Insured Healthcare Benefits (NIHB) program. For more information, contact Health Canada at 1-800-232-7301. Inuit people can also access PrEP through the HIV Drug Treatment program.

For Inuit people, filling a prescription for PrEP is the same as for any other prescription. The prescription from the doctor can be filled at any pharmacy in BC. The pharmacy will fill the prescription at no cost and there is no pre-approval form or process needed. 

For the latest updates on the roll-out of publicly-funded PrEP in BC, visit the Health Initiative for Men's GetPrEPed website or the BC Centre for Excellence website.

Things to consider

Any doctor licensed to practice in BC may enroll a person in PrEP and prescribe PrEP. Both doctors and nurse practitioners can authorize prescription refills for PrEP.

It’s important to take PrEP correctly and under the care of a health care provider. Though the medication is fairly safe, taking PrEP does require regular medical visits and blood and urine tests.

PrEP is not meant to replace other methods of HIV prevention. PrEP does not protect against other STIs. Condoms and other barrier methods are still recommended during penetrative sex to prevent HIV.

Resources

BC Centre for Excellence in HIV/AIDS – HIV Drug Treatment program information
CATIE.ca – Pre-exposure prophylaxis (PrEP)
CATIE.ca – 8 questions about PrEP for guys
GETPrEPED – PrEP information website for BC from the Health Initiative for Men 
The Sex You Want – PrEP information for gay and bisexual men (Toronto-based)
Canadian Guidelines – For PrEP and PEP
US Centres for Disease Control and Prevention – Pre-exposure prophylaxis (PrEP)

 

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