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How to get PrEP in Canada

How to get PrEP in Canada

Updated on:
November 9, 2021

Getting a PrEP prescription in Canada shouldn’t be a hassle. We’re here to help you navigate the Canadian health care system so you know where to get PrEP, and how.

PrEP is a daily pill to prevent HIV

PrEP is medicine and is short for Pre-exposure Prophylaxis. It is a once-per-day pill that reduces the risk of contracting HIV by up to 99%.

If you take PrEP daily, the presence of the medicine in your bloodstream helps stop HIV from taking hold and spreading in your body. Taking PrEP daily is optimal for maximizing effectiveness. Though it can also be prescribed as PrEP on demand. PrEP stops HIV in your bloodstream from replicating, eliminating the virus from your body when the original exposure amount dies. Essentially, PrEP works by ensuring HIV cannot replicate in your body and ensures you remain HIV negative.

Deciding to be on PrEP

The decision to be on PrEP is made between a patient and a healthcare provider. Before being on PrEP, it’s worth trying to better understand your risk of HIV transmission. Your risk of HIV is determined by your sexual and/or drug use behaviour, as well as your current use of prevention methods, like condoms and PrEP. Essentially, deciding to be on PrEP involves your need for an additional layer of HIV prevention.

After you’ve made a decision and spoken to your provider, some lab testing is required before you can get started on PrEP. The tests required will be blood and urine tests for HIV, STIs, and to ensure your body can tolerate PrEP.

There are a few options to getting started on PrEP:

1. Get PrEP online, with Freddie

With the advancement of modern technology came new ways to connect with health providers online, safely. Freddie is one of those options! With Freddie, you can speak to a provider, access your lab information, and have an easy hub for your PrEP care, all kept confidential and safe.

Freddie’s online services allow you to access PrEP care from the comfort of your home, guaranteeing that you’ll be speaking with a competent team of trained and inclusive providers.

At Freddie, we keep the process streamlined and your information safe so we can focus on our priority: offering easy and accessible PrEP to LGBTQ2S+ Canadians.

Freddie offers PrEP in two options: Generic Truvada, & Descovy. Both of which offer equal amounts of protection against HIV when taken daily.

If you’d like to get started with PrEP online, complete our 1-min assessment questionnaire and schedule your free consultation.

2. Talk to your family doctor about PrEP

Talking to your family doctor is often the first step taken to start PrEP. It’s important to have an honest conversation with your provider about why you think PrEP may be for you so they can provide you with all needed information and care. Doctors’ offices will often give you requisitions for HIV and STI testing, so you can attend a lab to get tested.

Unfortunately, many healthcare providers are unaware of PrEP and/or LGBTQ2S+ health, which can make for difficult conversations. When speaking to a provider, make sure you:

  • Have enough information about PrEP ahead of your conversation,
  • Go in confidently and ask for the services you need,
  • Respond to provider’s questions honestly, and
  • Understand your rights as a patient. Nobody has the right to shame you for your sexual / drug use behaviour, or to make you feel lesser due to your gender, sexuality, ethnicity, income, or ability.
  • 3. Go to a sexual health clinic / STI clinic

    Many patients get referred to PrEP prescribers through a sexual health clinic, or eventually visit an STI clinic for their lab tests. Being on PrEP requires that you take lab tests (blood, and urine) with some frequency. You will need to get tested before starting PrEP, after one month of PrEP, and every three months after that. This is done to ensure that you’re eligible for PrEP, your body is tolerating PrEP well, and any STIs are being detected and treated as soon as possible.

    STI clinics are usually more specialized in sexual health and wellness, meaning they provide a lot of testing and treatment services for STIs and HIV.

    When going to a sexual health clinic you can expect questions about your sexual and drug use behaviour so they can better understand your risk and screen you for relevant STIs. They’ll also draw your urine and blood samples (and sometimes swabs).

    PrEP costs in Canada in 2021

    As for the cost of PrEP, it is usually determined by what form of public health coverage is available, which changes according to which province you are in.

    In Alberta and Saskatchewan, PrEP is fully covered for those deemed to be at higher HIV risk. So, if you have a healthcare card and meet the criteria, you can access PrEP for free.

    In Ontario, and Quebec, there’s a ‘blended’ system, where PrEP is partly covered for some parts of the population, and can be fully covered for others. This usually depends on your income, age, and whether or not you have access to other benefits. In these two provinces, there can be a ‘copay’ associated with PrEP, that is, a portion of the price that is covered by you.

    For more information around costs & coverages in Ontario and Quebec see our full article on PrEP costs & coverage in Canada.

    In Ontario, those who are 24 years old or younger are covered by the Ontario Works or Ontario Disability Support Program (ODSP): you get free PrEP through provincial coverage with your health card! If you’re 25 or older, there’s usually a copay associated with PrEP in Ontario, but Freddie can help out with that!

    Freddie financial assistance

    In Ontario, Freddie offers a few programs for patients who are aged 25+ and need to pay for PrEP:

    Those with insurance: Our co-pay assistance program reduces the cost of the co-pay to $0 for the vast majority of patients.

    Those without insurance: We provide support to help reduce the cost of the Trillium Drug Program so that PrEP will either be free or low cost for you depending on your income.

    Freddie also provides three months of free PrEP while you wait for your coverage to kick in.

    In Quebec, our co-pay assistance program for patients with private insurance covers the cost of the copay associated with private lab testing. Financial assistance programs to help with the cost of PrEP itself are not allowed under Quebec law, unfortunately, so Freddie cannot offer them.

    Learn more about our financial assistance programs for PrEP.

    Reviewed by:
    Dr. Caley Shukalek

    Caley is passionate about evidence-based, patient-centred care, including telemedicine that can provide high quality care from wherever a patient may choose.

    He helped create Alberta's PrEP guidelines and works as a specialist in General Internal Medicine with additional training in sexual health, including HIV and sexually transmitted infections.

    He holds an Masters of Public Health from Johns Hopkins University, an MD from the University of Calgary and an MSc from the University of Alberta.