An article by Filip Rakic, a member of the GSA Gender and Sexuality Alliance Subcommittee
The goal of this blog post is to help graduate students navigate access to PrEP. As a student who has gone through this process, I thought it would be helpful to summarize the process and hopefully make things easier for anyone trying to access PrEP for the first time or as a refresher.
What is HIV?
Briefly, HIV stands for human immunodeficiency virus, and it is a virus that impacts your immune system. Anyone is capable of contracting HIV, however individuals in the queer community have historically been, and continue to be, at a greater risk of exposure. Therefore, it is of benefit to members of our community to be aware of methods of prevention, one of which is the use of PrEP.
What is PrEP?
Pre-exposure prophylaxis, or PrEP, is a daily pill that prevents HIV. When taken every day, PrEP is 99% effective in reducing the risk of contracting HIV. In Canada, the brand of PrEP is Truvada, which was approved in 2016 and is a combination drug (Tenofovir disproxil fumarste/Emtricitabine), though there is also a generic version available, making PrEP more accessible and affordable.
What does it do?
PrEP can be seen as a chemical barrier to HIV infection, while a condom could be seen as a physical barrier. What PrEP does is it prevents HIV from replicating, so that it cannot infect your immune system. Full protection from PrEP occurs after 7 days of daily use for anal sex and 21 days for vaginal sex.
About 10% of users will report side effects, however these generally go away quickly. Short-term side effects include nausea, headaches, diarrhea, and vomiting. While long-term effects, though quite rare, include reduced kidney function and bone density. In order to stay on PrEP, you have to be tested for these side effects every 3 months via routine bloodwork to ensure you are not experiencing one of these rare events.
For most Canadians, PreP is either free or low-cost. As a GSA member, you can get brand name PrEP covered if you are enrolled in the medical insurance policy or seek the generic version through the province. In Alberta, if you are designated at-risk of HIV exposure, you are eligible for a no-cost prescription. To be covered provincially, you will first need to be an Alberta resident with a valid health card, and second, meet the clinical criteria to qualify. This policy outlines three main eligible groups. First, are males who have sex with males, and/or penis owners. Second, are intravenous drug users and third, are people engaging in high-risk exposure activities. These are generalizations and each person’s situation on whether PrEP is right for them should be discussed with a designated PrEP provider.
Here are two main ways to access PrEP in Alberta:
1. The first is through your family physician – the list of designated PrEP prescribers in Alberta can be found here: https://www.albertahealthservices.ca/assets/info/hp/srh/if-hp-srh-hiv-prep-designated-providers.pdf. Physicians on the list are familiar with the medication and are a safe resource. At your appointment, you should expect to be asked a series of questions regarding your sexual behaviour to determine your eligibility. You’ll be asked to do some bloodwork, and then you should be able to get your prescription. After 30 days, you will have to complete bloodwork again to ensure you are tolerating the medication and if everything is okay, then these check-ups switch to every 3 months.
2. Your second option is to use online telemedicine services – the most common in Calgary is called Freddie (https://www.gofreddie.com). They will pair you with an approved prescriber remotely and get you a lab requisition to undergo the same process described above.