5 Things We Learned at Behind The Scene: PrEP School!

At our February edition, Dr. Paul MacPherson from the Ottawa Hospital and Derek Cassidy, MAX Ottawa’s Mental Health and Wellness Coordinator, presented information for guys into guys to understand what PrEP is, how it works, and where to get it.

1)PrEP, or pre-exposure prophylaxis, is a daily medicine that can reduce your chance of getting HIV. Truvada is the brand name. It is also jokingly called, “the blue butt pill” amongst some community members. PrEP works by not allowing the virus to take hold and spread to your body. Daily use reduces the risk of getting HIV from sex by more than 90%. Among people who inject drugs, it reduces the risk by more than 70%. Your risk of getting HIV from sex can be even lower if you combine PrEP with condoms and other prevention methods.

2) PrEP should be considered if you’re a guy into guys as part of a strong HIV prevention strategy. It’s strongly recommended for those who

1. have an HIV-positive partner;
2. have multiple partners, a partner with multiple partners, or a partner whose HIV status is unknown;
3. have anal sex and use condoms infrequently;
4. recently had a sexually transmitted disease (STI);
5. or participate in other riskier activities such as drug use or sex work.

3) Prep is a fairly safe medicine however, there are required steps to getting it. You first must

1. Talk to your medical doctor (MD) or nurse practitioner (NP) who will order blood tests including an HIV test. This is because you must be HIV negative before starting PrEP. Other tests will check how well your kidneys are working and a hepatitis panel.
2. If your doctor is unwilling to prescribe PrEP, you can get a referral to an infectious disease specialist through a sexual health clinic
3. Your MD/NP will follow up and write a one-month prescription if your tests are within expected range.
4. You’ll doctor/NP will schedule regular appointments every 3 months to check in, for routine STI and HIV testing, and to monitor kidney function and other side effects.

4) Truvada (the brand name for the drugs used as PrEP) recently went generic, lowering their costs from around $1000 per month to about $250 per month. This is still quite expensive, but there are a couple of options for coverage in Ontario:

1. Ontario recently included PrEP in their drug formulary, which means that anyone that accesses drugs through the Ontario Drug Benefit (ODB) will now have their drugs covered.
2. The ODB is available to people using Ontario Works (OW), the Ontario Disability Support Program (ODSP), OHIP+ (for people 24 years and younger), or Trillium
3. Most extended health care drug coverage plans should cover it.
4. First Nations and Inuit guys with status can access PrEP under NIHB.

5) Despite the benefits of taking PrEP, many MD’s and NP’s are not comfortable or as knowledgeable about it as expected. You also may feel not feel comfortable discussing your sex life with them. A solution can be coming to GayZone, Ottawa’s GBT2Q guy friendly sexual health clinic, on Thursday evening from 5:00-8:00 p.m. at the Centretown Community Health Centre, located at 420 Cooper Street. You can also request a referral to meet with Dr. MacPherson at the Ottawa Hospital from GayZone, your MD or NP, or a health clinic.

For guys who live on the Gatineau side PrEP is covered by the RAMQ. You can call Dr. Rémi De Champlain/ Médecine Familiale Montclair by calling 819 772-2003. You can also contact the Clinique immuno déficience/Gatineau Hospital at 819 966-6199.

If you have any questions or comments, feel free to contact MAX Ottawa