What is PrEP?

PrEP (pre-exposure prophylaxis) is the use of oral antiretroviral drugs to prevent HIV in people with ongoing potential exposures to HIV through sex or injection drug use. In 2016, Health Canada approved tenofovir disoproxil fumarate and emtricitabine (TDF/FTC), originally a component of HIV treatment, for PrEP. In December 2020 Health Canada approved tenofovir alafenamide and emtricitabine (TAF/FTC) for PrEP. Both options are available in a combined single tablet and administered once daily as PrEP.

What is PrEPStart?

PrEPStart provides three months of free PrEP for people at risk of HIV who do not currently have drug coverage. This initiative lets them start PrEP right away and gives them three months to arrange drug coverage so they can stay on PrEP as long as needed.

Why create PrEPStart?

Most people in Ontario already have a private or public drug plan that will cover all or most of the cost of PrEP. However, some people don’t have drug coverage and are not sure of the best way to pay for PrEP.

PrEPStart was created to give those individuals access to PrEP while they figure out which private or public drug program is best for them.

Although Ontario does not cover the full cost of PrEP for everyone at risk, there are many public drug plans that provide access to PrEP at little or no cost. PrEPStart provides information on the different ways to pay for PrEP and will connect people with someone who can help them apply for ongoing drug coverage.

What do I need to do for my patient to access the program?

The process for enrolling your patients is simple and requires no additional clinical work.

  1. Complete a standard PrEP assessment for your patient including assessment for HIV risk and screening bloodwork. If this is your first time prescribing PrEP, review this short training video on PrEP initiation.
  2. Once you have the bloodwork results and have confirmed the patient is eligible for PrEP, complete the PrEPStart prescription form and fax it to the program pharmacy at 416-926-9898. The pharmacy will fill the prescription and contact the patient who will either pick up their medication (if living in Toronto) or have it shipped to them (if they live outside Toronto).
  3. Talk to your patient about their options for drug coverage so they can continue on PrEP once their initial three-month supply runs out. Click here to see the different options your patients have for PrEP coverage . If your patient needs support applying for coverage, they can contact the PrEPStart support line at 416‑903‑9992 or by email at [email protected].

What ongoing follow-up is needed for patients on PrEP?

All patients on PrEP should be screened every three months for STIs, HIV and creatinine. This screening includes swabs for oropharyngeal and rectal STIs, which can be sent to the public health lab for testing.