If you want to get PrEP, you have to ask a doctor or nurse.
They’ll talk to you about why you might need PrEP. If you both agree that PrEP is right for you, they’ll go ahead and give you an HIV test to make sure 
you’re negative, give you tests for STIs, and test to make sure that your kidneys are healthy. If everything looks good, they’ll write you a prescription. While you’re on it, you may need to get these tests every 3 months.
Not every doctor will respond the same way to a conversation about PrEP, so it’s best to be prepared for what that conversation might look like.
Health Canada has approved the drugs emtricitabine and tenofovir for use in combination with safer sex practices to reduce the possibility of sexually acquired HIV. Typically, Truvada or Descovy – the brand names of PrEP – will cost up to $800-1000 a month. However, cheaper generic versions of the drug can be as low as $250 a month at some pharmacies across Ontario. Generics have been approved by Health Canada and are as effective as Truvada.
If you have private health insurance — including through your work or school — then your plan may cover some or all of the cost of PrEP.
In September 2017, the Ontario government added PrEP to its provincial formulary. This means that if you have difficulties getting coverage, you can apply to receive coverage through the Trillium Drug Program, Ontario Disability Support Program, and Ontario Works. You must have a valid Ontario health card in order to be eligible. If you have questions about coverage, you should talk with somebody from an HIV/AIDS service organization, people who do HIV testing, or organizations that work in sexual health.
PrEP is also covered for guys under 25 through the OHIP Plus program. However, only guys who do not have private insurance are eligible. Again, you must have a valid Ontario health card.
Refugees in Canada can access PrEP through the Interim Federal Health Program. You can also access PrEP via your Canadian Forces Health Care Identification Card or Veterans Affairs Canada Health Program. Visitors to Canada who aren’t permanent residents, but who have foreign coverage can also import their medications to Canada.
Get started on PrEP now through the PrEPStart program while you’re figuring out what coverage works for you.
If you’re thinking of asking your doctor about PrEP, but you’re afraid you won’t know how to ask about it, check out the script below. You can even download it and take it with you.
PrEP is now available for delivery in Canada from online clinics. Several online PrEP delivery services exist. Online clinics have patients fill out a digital intake form and attend a virtual appointment, they order lab tests that you’ll go complete at a local lab to make sure PrEP is right for you, then you’ll have PrEP delivered to your door. You’ll be required to go in to your local lab for testing every three months, but you won’t have to go to a doctor’s office.
The full cost of Truvada as PrEP is covered by the Non-Insured Health Benefits (NIHB) Program. NIHB is a federal program that covers costs for certain medications and other health resources for some First Nations and Inuit people. Eligibility to receive NIHB has some restrictions based on a person’s legal recognition as part of First Nations or Inuit communities and their residency status. If you are a First Nations or Inuit person and are not sure if you are eligible for NIHB, you can contact the Ontario office of NIHB at 1-800-640-0642 or NIHB National Headquarters at 1-866-225-0709.
We’re at an exciting time in HIV treatment and prevention. The science of anti-retrovirals like PrEP, HIV treatment and PEP has changed rapidly, and already the medications people use for these treatments have gotten easier to take and have fewer side effects. It’s very possible that new developments will make PrEP and HIV treatment even better, such as taking injectable treatments or other changes in the use and availability of these drugs.
