Frequently Asked Questions

Yes, absolutely. It's very simple.

You can transfer only your PrEP prescription or your entire file to us to take advantage of our fast, discreet delivery services and our specialized approach to sexual health.

How do I make the transfer?

You can either contact us directly by phone or email, or fill out our online transfer form. Our team will handle the entire process for you, hassle-free.

What about my medical follow-up?

The choice is yours! You can continue your follow-ups with your current doctor or nurse, or you can entrust all of your care to our PrEP clinic. Together, we will create a care plan that respects your preferences and comfort level.

Don't worry, we can help you renew your PrEP quickly.

Every situation is different, but our goal is to ensure you have simple, safe access to PrEP, without unnecessary delays or judgment.

If your previous prescription was from our pharmacy:

Contact us directly through our contact page or our secure messaging app, AIRIX. We will assess your situation to ensure a fast and safe renewal of your treatment.

Depending on how much time has passed, new screening tests (for HIV, STIs, and kidney function) are required before continuing. We will guide you to the simplest and most accessible testing options for you.

If your prescription was from another pharmacy:

Contact us anyway. We have several solutions for you. We can handle the transfer of your file or schedule a consultation with our clinical team for a new prescription.

Signing up is simple, fast, and takes just three easy steps.

The entire process is designed to be completely confidential and does not require a doctor's referral.

1. Create your secure account

Click the "Get Started" button to access our platform. There, you will create your account and fill out a short medical questionnaire to assess your needs.

2. Schedule your consultation

Once the questionnaire is submitted, you can choose a time slot for your consultation. You can have it by phone or in person at the pharmacy, whichever you prefer.

3. Meet with a professional

During this meeting, one of our healthcare professionals will confirm that PrEP is a good option for you, answer your questions, and, if appropriate, can prescribe the treatment.

Our process is designed to be simple, fast, and confidential.

Here are the three main steps to starting PrEP with us, often in just a few days.

1. Initial consultation

After filling out our online questionnaire, you will schedule a meeting (by phone or in person) with one of our professionals. During this consultation, we will confirm that PrEP is a good option for you, answer your questions, and choose the type of PrEP that best suits your needs together.

2. Screening and lab work

We will then prescribe the required lab tests (for HIV, STIs, and kidney function). You can complete these tests at a lab near you, at a public screening center, or directly with our nurse at the pharmacy.

3. Starting your treatment

Once we receive your lab results, we can provide you with your first PrEP treatment. You can pick it up in person or opt for our free, fast, and discreet delivery anywhere in Quebec.

Before starting PrEP, a complete medical workup is required for safety reasons:

• HIV screening test: It is imperative to confirm that you are HIV-negative before starting PrEP. A 4th generation blood test is preferred for its reliability. (Self-tests or rapid tests are generally not sufficient in this context).

• General blood work: This includes a kidney function test (creatinine measurement) because, depending on the PrEP option chosen, one of the medications can slightly affect the kidneys. It is recommended to verify that your kidneys are functioning well before and during treatment.

• Hepatitis screening: A hepatitis B serology test is often done, as the PrEP treatment (containing tenofovir) acts on this virus. If you have hepatitis B, PrEP must be managed with caution. A hepatitis C test and updating your vaccines may also be suggested.

• Other STI screening: A complete screening for sexually transmitted infections is usually offered at the same time (e.g., syphilis via blood test, and gonorrhea/chlamydia via urine and/or throat/anal swabs, depending on your practices).

• Other tests: For female patients, a pregnancy test may be performed. The healthcare professional may adapt the workup to your personal situation.

In summary, this initial workup aims to ensure you do not already have HIV, that you have no medical contraindications, and to treat or vaccinate if needed for other infections. While this may seem like many tests, they are generally grouped into a single blood draw and a few swabs, usually done in one visit.

We will guide you to easily complete the initial workup. Several options are available:

• At an STI screening clinic: You can choose a clinic that performs sexual health screenings. We will send you a requisition for the additional required tests (e.g., for kidney function) which you can give to the clinic at the time of your appointment. You can find a list of sexual health clinics in Quebec here.

• At a medical analysis laboratory: We will send you a requisition to perform the required tests. You can then go to a lab of your choice for the blood draw and sample collections. If you choose a private lab, most private insurance plans reimburse the fees.

• At our pharmacy: With our clinical nurse, we offer appointments for HIV, STI, and complete sample collection for patients followed by our PrEP clinic. The $45 fee is all-inclusive and is reimbursed by most private insurance plans. Book an appointment on our Clic Santé page.

In any case, the procedure will be explained to you step by step.

Generally, the process is fast: often a week or less.

The main delay depends on the time it takes to complete your lab tests. Here is an idea of the typical timeline:

The usual process

• Sign-up and consultation: These steps are done quickly, often on the same or the next day.
• Lab work: This is the step that can vary. Once you have completed your screening appointment, we generally receive the results within a few days.
• Starting treatment: As soon as we have your results and everything is in order, we can provide you with your treatment.

In practice, a patient who signs up at the beginning of the week can often start their treatment before the following weekend.

Exceptions and special situations

• Injectable PrEP: We must wait for your HIV test result before the first injection. A short additional delay may be needed to schedule this first injection appointment.
• Urgent need: If you have an urgent need (an upcoming trip, for example), please inform the pharmacist. Temporary solutions, such as starting with PEP, can sometimes be considered.
• Existing results or vaccines: If you have recent test results or if your vaccinations are up to date, this can speed up the process.

Our goal is to give you access to PrEP without unnecessary delays, while ensuring your safety at every step.

Both approaches are effective and recognized; the best choice depends on your needs.

The important thing is that you receive quality support with which you are comfortable. Both remote consultations and in-person meetings have their advantages.

Why is a remote consultation an essential option?

Recommended by studies and organizations like the World Health Organization (WHO), telehealth is a crucial tool for improving access to HIV prevention. It offers:

• Discretion and comfort: Many people find it easier to discuss sexuality or identity without the stress of a face-to-face meeting.
• Accessibility: It is a vital solution for people in remote regions or in environments where stigma is a barrier to care.
• Time savings: It eliminates the travel and waiting room time often associated with traditional appointments.

The importance of trust and expertise

Whether remote or in-person, the bond of trust with your healthcare professional is paramount. Optimal PrEP follow-up requires more than just a prescription; it demands sharp expertise.

While the law allows all pharmacists in Quebec to prescribe PrEP, safe and adapted support requires specific sensitivity and knowledge (of LGBTQ+ issues, transcultural realities, etc.). Our team is dedicated to sexual health and undergoes continuous training to guarantee this level of expertise.

What if I prefer an in-person meeting?

That is absolutely possible, and we will welcome you warmly. Direct human contact is valuable, and we offer confidential consultations at our pharmacy for those who prefer it. You can also choose a local pharmacist with whom you already have a relationship of trust.

The limits of remote services to be aware of

Transparency is essential. Telehealth has its limits:

• Certain urgent situations, like PEP (post-exposure prophylaxis), or the need for a physical exam (blood pressure check, etc.) are not suitable for this format.
• Technology carries inherent risks to confidentiality, even with secure platforms.

In any case, an in-person follow-up can be arranged if needed.

Clic here for a list of other PrEP ressources in Quebec!

PrEP is an extremely effective HIV prevention strategy, similar to a birth control pill, but for HIV. It involves taking a medication before a potential exposure to the virus to prevent it from infecting you.

How does it work?

PrEP (Pre-Exposure Prophylaxis) is an antiretroviral treatment that an HIV-negative person takes before and during periods of risk. The medication spreads throughout your body and creates a kind of "shield" that prevents HIV from establishing itself and multiplying if you are exposed to it.

Therefore, if you take PrEP correctly, the virus cannot infect your cells and you remain HIV-negative.

What you need to know

• Targeted protection: PrEP only protects against HIV. It does not prevent other STIs.
• It is not a vaccine or a cure: The protection lasts as long as the treatment is taken correctly.
• For complete information: Click here to learn all about PrEP.

When taken correctly, PrEP is extremely effective, reducing the risk of contracting HIV by over 99%. The effectiveness of oral PrEP is directly linked to your adherence. It is a reliable and essential prevention tool.

The key: taking the treatment as prescribed

Studies show that protection is at its maximum (over 99%) for people who take their treatment rigorously (every day or according to the recommended schedule). Poor adherence, such as frequently missed doses, significantly reduces this effectiveness.

A new option: injectable PrEP

Injectable PrEP is a new option that provides constant protection without having to think about taking pills. An injection every two months protects you at all times.

PrEP: one tool in a global health strategy

While highly effective against HIV, PrEP should be part of a comprehensive prevention approach that includes:

• Regular screening for other STIs.
• Prioritizing Condom use depending on the context.
• Vaccination (hepatitis B, HPV).
• The knowledge of your partner's status, including that U=U (Undetectable = Untransmittable): a person living with HIV on effective treatment does not transmit the virus.

Protection is not always instantaneous; the time it takes to become effective depends on the type of PrEP you are using.

Each method has its own protocol for achieving maximum protection.

Daily Oral PrEP

This is the most studied method. The delay varies depending on the type of sexual intercourse:

• For anal sex: Protection is optimal after 7 days of continuous daily use.
• For vaginal sex: Protection is optimal after 21 days of continuous daily use.

On-Demand Oral PrEP (2-1-1)

This method provides very rapid protection for anal sex only.

• Protection: Effective as soon as 2 hours after the initial double dose (2 pills), as long as the full protocol (2-1-1) is followed correctly.

Injectable PrEP

This method provides continuous protection for all types of sexual intercourse.

• Protection: Protection is considered optimal 7 days after the first injection.

It is essential to respect these timelines and to use additional protection (like a condom) until maximum protection is achieved.

No, not necessarily. There are two dosing schedules for oral PrEP, and the choice depends on your needs.

Both methods are highly effective when followed correctly. Your pharmacist will help you choose the best option for you.

Option 1: Continuous PrEP (daily use)

This is the most common schedule and the only one recommended for all types of sexual intercourse (anal and vaginal).

• How it works: You take one pill every day, at around the same time.
• Ideal for: People who have frequent or unpredictable sex, or for anyone who has vaginal sex. It is also the only option for people living with chronic hepatitis B.
• Advantage: It provides constant, maximum protection without needing to plan ahead and predict your sexual activity.

Option 2: On-Demand PrEP (2-1-1 schedule)

This flexible method is a validated option for anal sex only (active or passive).

• How it works (2-1-1 protocol):
  1. Take 2 pills at the same time, between 2 and 24 hours before sexual intercourse.
  2. Take 1 pill, 24 hours after the first dose.
  3. Take 1 final pill, another 24 hours later (48 hours after the first dose).
• Ideal for: People who can anticipate their sexual activity or who have sex more occasionally.
• Advantage: It reduces the total number of pills you need to take.

Important: Never switch your dosing schedule without talking to a healthcare professional. The on-demand schedule must be followed exactly to be effective.

The decision to stop PrEP should always be discussed with a healthcare professional. This ensures you stop safely and allows you to plan the next steps. You cannot simply stop the treatment the day after a risky sexual encounter.

Stopping Oral PrEP (pills)

To be protected from an exposure that might have occurred during your last sexual encounter, you must continue taking the pills for a certain period afterward (this is often called the "tail").

• After anal sex:

  • If you are on daily PrEP, it is recommended to continue it for 2 to 7 days after the last potential exposure. Your pharmacist will tell you the exact duration for you.
  • If you are on on-demand PrEP (2-1-1), the protocol already includes the post-intercourse doses. Just make sure you complete it correctly.

• After vaginal sex:

  • It is recommended to continue PrEP for 7 days after the last potential exposure.

Stopping Injectable PrEP

Stopping injectable PrEP is more complex because the medication stays in your body at a slowly decreasing concentration for several months.

• Risk of resistance: During this period, if you are exposed to HIV, the virus could develop resistance to the medication.
• Mandatory prevention: For this reason, it is crucial to use another prevention method (like oral PrEP or condoms) for up to a year after your last injection.

Restarting PrEP is always an option

Life changes, and so do your prevention needs. If you want to restart PrEP after a break, it's simple: you just need to complete a new round of screening tests and consult a professional. Never resume taking old pills without new medical advice.

Yes, the decision to stop is yours, but a safe discontinuation must ALWAYS be planned with your healthcare team.

Unlike with pills, you cannot simply stop getting injections. It is crucial to plan the process to avoid significant risks.

Why is a planned discontinuation essential?

The injectable PrEP medication remains in your body for several months after the last injection (the pharmacological "tail"). During this period, the medication level is too low to effectively protect you, but high enough that, if an infection were to occur, HIV could develop drug resistance. This is the risk we absolutely want to avoid.

The safety strategy: transitioning to oral PrEP

To eliminate this risk, the standard recommendation is to switch to PrEP in pill form (oral PrEP) to cover the "tail" period. This transition ensures your HIV protection remains at 100% while the injectable medication leaves your body.

What if my risk of HIV exposure disappears completely?

If your situation changes and you are no longer at risk (e.g., a stable, monogamous relationship with an HIV-negative trustworthy partner, abstinence), discussing the discontinuation of PrEP is entirely relevant.

Even in this case, it is essential to plan this with a healthcare professional like our pharmacists. We will evaluate your situation together. A transition to oral PrEP might still be recommended for maximum safety, or another follow-up strategy could be considered. The important thing is that the decision is made in an informed and safe manner.

Your action plan for a safe discontinuation

1. Discuss your plan to stop with us well before your next scheduled injection.
2. Plan the transition or follow-up strategy with our team.
3. Ensure your protection for the full recommended duration to guarantee your safety.

The good news: many solutions exist to make PrEP accessible, regardless of your situation.

The final cost to you depends on your insurance coverage. Here is how it generally works in Quebec:

If you are covered by RAMQ (public plan)

PrEP (generic and certain brand names) is covered. You will only pay a portion of the cost each month until you reach a maximum annual cap, which makes the expense predictable.

If you are covered by private insurance

All private plans in Quebec cover PrEP, but the reimbursed amount varies. A personalized quote is therefore essential to know your share of the cost.

How can so many people say they pay $0?

This is thanks to the financial support programs from drug manufacturers. These programs often cover the portion you would normally have to pay after your insurance (public or private) pays its share, making the final out-of-pocket cost minimal or even zero for many people.

Why can't we display prices?

Our code of ethics prohibits us, as pharmacists, from publicly advertising the price of prescription drugs. This rule ensures that the discussion about cost takes place within a professional consultation where we can analyze your overall situation but sadly prevents us from providing more detailed information.

The best way to know: a simple and confidential quote

The best first step is to contact us. With your insurance card, our team can tell you, free of charge and confidentially, exactly how much each PrEP option would cost you. We will also check your eligibility for support programs to find the most advantageous option.

Please note: Injectable PrEP is also covered by all Quebec insurance plans, including RAMQ.

Want more information?

Visit https://maprep.org/accessibilite/ (only in french) or for more information in english, visit gofreddie.com/prep-cost

For continuous protection, plan your renewals and screenings every 3 to 4 months.

Don't wait until you run out of medication. Here's how to ensure a simple, uninterrupted renewal process.

How to renew your PrEP

1. Place your renewal order.
Whether your prescription is still valid or has expired, the first step is the same: order your medication using the method of your choice on our Order page.

2. Complete the follow-up questionnaire.
If your prescription has expired, you will need to fill out a short, secure online questionnaire. This allows us to check if everything is going well with your treatment. A pharmacist will call you if a follow-up is necessary.

3. Get your screening tests done.
To renew your PrEP, a screening (for HIV, STIs, and kidney function) is required every 3 to 4 months for your safety. We monitor your results and will send you the lab requisition if needed. You can get your samples collected wherever you prefer, including at our pharmacy.

The key message

By planning a "check-up" (placing your order and getting screened) every 3 months, you ensure you never run out of PrEP and can continue your prevention safely. If you have any doubts, contact us without delay.

No, not necessarily. While it is an excellent option, the decision is always made with a healthcare professional.

Certain medical or personal situations mean that Apretude® may not be the right choice, or that it must be used with special precautions.

In which cases is Apretude® strictly contraindicated?

You should never take Apretude® in the following situations:

• If you are HIV-positive or if your status is unknown. Apretude® is a prevention tool, not an HIV treatment. A negative screening test is mandatory before starting.
• If you have a known allergy to cabotegravir or any of its other ingredients.
• If you are taking certain specific medications that interact with it (notably for epilepsy or tuberculosis).

Other important situations to discuss with your team

These points are not absolute contraindications, but they are essential to discuss to ensure your safety:

• Commitment to the schedule: Injectable PrEP requires in-clinic injections every 8 weeks. If this rhythm is difficult for you to maintain, oral PrEP might be a better option.
• Liver problems: Inform us if you have a history of liver issues (such as hepatitis B or C).
• If you have had gluteal filler injections (e.g., silicone). The Apretude® injection is administered into the gluteal muscle. The presence of fillers can interfere with the administration and absorption of the medication, and the safety of this practice has not been studied. This is a crucial point to discuss.

The key: an informed and shared decision

Our role is to help you choose the PrEP option that best suits your health, your daily life, and your preferences, with complete confidence.

The program is simple and easy to follow, with about 6 injection appointments per year once the maintenance phase begins.

Here is how the journey unfolds, step by step.

Step 1: The initiation phase (the first 2 doses)

This phase quickly "loads" the medication into your body to achieve optimal protection.

1. Oral lead-in phase (optional): Before the first injection, you can choose to take the medication in pill form for one month to test your tolerance.
2. First injection: Administered after a negative HIV test.
3. Second injection: Scheduled exactly 4 weeks later.

Step 2: The maintenance phase

Once the initiation is complete, you settle into a regular rhythm.

• You will then receive an injection every 8 weeks (every 2 months).
• A flexibility window of ±7 days around the scheduled date is possible.

Medical follow-up: a priority for your safety

Follow-up is essential and very similar to that for oral PrEP.

• HIV test before each injection: A rapid test or blood draw is mandatory before every administration to confirm your negative status.
• Overall follow-up: Screening for other STIs continues at the same pace, usually every 3 to 6 months.

Flexibility and practical aspects

• The injection: It is quick and administered into the gluteal muscle by a healthcare professional. Some tenderness at the injection site for a few days is normal.
• Travel or trips: If you anticipate a delay for your injection, notify us as soon as possible. We can plan a "bridging" solution with pills so your protection is never interrupted.
• Injection location: You can receive your injections for free in our private room at the pharmacy, or we can deliver the medication to the injection site of your choice.

As a general rule, PrEP is compatible with most medications. However, there are some important interactions to be aware of.

Here is an overview of possible interactions, divided by category.

Interactions with prescription drugs

• Hormone treatments: Whether for contraception or gender-affirming hormone therapy, studies are clear: there is no significant interaction. The effectiveness of both PrEP and your hormones is maintained.

• Drugs affecting the kidneys (NSAIDs): This is an important point of vigilance. Frequent or high-dose use of non-steroidal anti-inflammatory drugs (ibuprofen, naproxen, etc.) can increase the risk to your kidneys, especially with PrEP formulations containing TDF (Truvada® and its generics). Occasional use is generally safe, but discuss it with us if you take them regularly.

  • Alternative: Descovy® (containing TAF) has a much lower impact on the kidneys, making this precaution less critical.

• Certain epilepsy and tuberculosis drugs: Medications like rifampin (tuberculosis) or carbamazepine (epilepsy) can reduce the effectiveness of PrEP. A discussion with your pharmacist is essential if you are taking these treatments.

Use of alcohol and recreational drugs

There are no known direct pharmacological interactions between PrEP, alcohol, and recreational drugs. Using these substances will not cancel out the protective effect of the medication.

The main risk is behavioral: excessive use can lead to missed pills, which compromises your protection. The key is to continue taking your treatment as prescribed.

The key role of your pharmacist: safety first

For safe PrEP use, transparent communication is paramount.

Your pharmacist has an overview of all your treatments (thanks to the Quebec Health Record - DSQ) and is in the best position to detect and prevent potential drug interactions. To ensure this safety:

1. Centralize your prescriptions at a single pharmacy.
2. Inform us of EVERYTHING you take: over-the-counter drugs, natural health products (St. John's wort is not recommended), etc.
3. Adhere to your medical follow-up and lab tests every three months.

This close collaboration between you, your doctor, and your pharmacist ensures maximum safety and effectiveness.

It is a new PrEP option that replaces the daily pill with a long-acting injection.

The medication used is cabotegravir (sold under the brand name Apretude®). It works on the same principle as oral PrEP—maintaining a concentration of the drug in the body to block HIV—but its formula allows it to be released very slowly, providing continuous protection. After a start-up phase, the schedule consists of one injection every two months.

What are the advantages of injectable PrEP?

Studies show that injectable PrEP is even more effective than oral PrEP because it eliminates the risk of missed doses, which is the main factor that can reduce the effectiveness of the pills.

People also choose it for several reasons that improve their quality of life:

• Less mental load: No longer having to think about taking a pill every day frees up considerable mental space.
• More spontaneity and discretion: Protection is constant without daily action and with no pill bottles to manage.
• A solution for adherence challenges: It is an ideal option for people with irregular lifestyles (variable work schedules, frequent travel).
• Avoiding gastrointestinal effects: The injection bypasses the digestive system, which is an advantage for those who are sensitive to GI side effects.

Is it the best option for everyone?

Not necessarily. Despite its advantages, it requires a commitment to visit a clinic every two months for injections. Discontinuing the treatment is also more complex than with oral PrEP.

The best approach is to discuss it. Our pharmacists are here to help you choose the treatment that best suits your reality, preferences, and lifestyle.

No, PrEP only protects against HIV. This is an essential point: PrEP is an extremely effective tool against the HIV virus, but it offers no protection against other sexually transmitted and blood-borne infections (STBBIs) like chlamydia, gonorrhea, syphilis, or herpes.

What does this mean for you?

Even while on PrEP, it is important to continue using other methods of protection for your overall sexual health. PrEP does not replace other prevention strategies.

Adopt a combined prevention strategy

For complete protection, your best approach is to combine several tools:

• PrEP: For highly effective protection against HIV.
• Condoms: Remain the best barrier against most other STIs.
• Regular screening: Getting tested every 3 months allows for the quick detection and treatment of any new infection.
• Vaccination: Vaccines are available to prevent certain infections, such as hepatitis B and HPV.
• Doxy-PEP: A new approach to reduce the risk of contracting certain bacterial STIs after sexual intercourse.

Please note: PrEP is also not a contraceptive and does not prevent pregnancy.

Unexpected things can happen. The important thing is not to worry and to contact us as quickly as possible.

This is the most important step. Here are the most common scenarios:

• If you are less than 7 days late: It is generally possible to receive your injection without any issues. Contact us to reschedule an appointment quickly.
• If you are more than 7 days late: A bridging solution will likely be necessary to ensure continuous protection.

The solution for planned absences (trips, etc.): the oral bridge

If you know in advance that you will be unable to make it to your appointment, the best solution is to plan ahead.

• How it works: Your healthcare team can prescribe you cabotegravir in pill form (Vocabria®), which is the oral version of your injection.
• Your role: You take one pill per day during your absence to "bridge" the injection and maintain 100% protection.

The key is communication. We are here to offer the flexibility needed so that PrEP adapts to your life, not the other way around.

The right response depends on your dosing schedule. Here is a guide for each situation.

If you take daily PrEP (1 pill per day)

• A single, occasional missed dose:

  • Take the missed pill as soon as you remember, then resume your normal schedule. Never double the dose.
  • While a single missed dose only slightly reduces protection if you've been taking PrEP for more than 7 days, consistency is key to its effectiveness. If condomless penetrative sex occurred during this period, please contact us. We will take the time to analyze the situation with you to provide safe, personalized advice.

• Several consecutive missed doses:

  • Consider your protection to be reduced. Use additional protection (a condom) for the next 7 days of daily intake to re-establish full protection. If condomless penetrative sex occurred during this period, please contact us. We will take the time to analyze the situation with you to provide safe, personalized advice.

If you take on-demand PrEP (2-1-1 schedule)

This schedule requires strict adherence. Any deviation can compromise your protection.

• Forgetting the 2 pills BEFORE sex: You were not protected by PrEP.
• Forgetting a pill AFTER sex: The effectiveness of PrEP could be reduced.

What to do in case of a significant mistake?

If you think your protection was compromised and you had a risky sexual encounter, contact us immediately. We can assess the situation with you and discuss the relevance of PEP (post-exposure prophylaxis), an emergency treatment.

Tips to avoid missed doses

• Set a phone alarm or use a pill organizer.
• If you frequently miss doses, talk to us. Injectable PrEP might be a better option for you.

Both methods effectively protect you from HIV, but they have distinct profiles regarding protocol, efficacy, and side effects.

The choice between them depends on your lifestyle and what you prioritize.

Rhythm and administration

• Oral PrEP: Requires daily discipline (or rigorous planning for the "on-demand" schedule). It is self-administered.
• Injectable PrEP: Consists of an in-clinic appointment every two months for an injection administered by a healthcare professional.
  • Our service to make your life easier: To offer you maximum flexibility, we can administer the injection in our private room at the pharmacy, coordinate the delivery of your medication to another clinic, or discuss remote or at-home service options with you.

Clinical effectiveness

• Clinical studies have demonstrated that injectable PrEP offers superior protection against HIV compared to oral PrEP. Furthermore, one of the major advantages of the injection is that it eliminates the risk of missed doses, a critical factor for ensuring the effectiveness of oral PrEP.
• When taken rigorously as prescribed, oral PrEP offers protection that exceeds 99% against HIV transmission.

Tolerance profile and common side effects

• Oral PrEP: Very well-tolerated. Mild start-up effects (nausea, headaches) are possible. Kidney function is monitored as a precaution.
• Injectable PrEP: Bypasses the digestive system but frequently causes normal and temporary reactions at the injection site (pain, tenderness).

Time to effectiveness

• Oral PrEP: Effective after 7 days (for anal sex) or 21 days (for vaginal sex). (2 hours for on-demand oral PrEP)
• Injectable PrEP: Effective 7 days after the first injection for all types of sex.

Comparative summary: Pros and Cons

Oral PrEP (Pills)

• Pros: Flexibility (allows for "on-demand" use), autonomy, simple and quick to stop.
• Cons: The mental load of a daily pill, risk of missed doses compromising protection.

Injectable PrEP

• Pros: Peace of mind (no daily management), demonstrated superior efficacy, discretion.
• Cons: Appointment commitment, injection site reactions, complex discontinuation process that must be planned.

The choice is yours: the flexibility of the pill or the peace of mind of the injection.

Yes, injectable PrEP is an extremely effective option and is increasingly accessible in Quebec. Here are the details to answer these two excellent questions.

A superior effectiveness

Yes, clinical studies demonstrate that injectable PrEP offers superior protection against HIV compared to oral PrEP.

One of the clear advantages of the bimonthly injection is that it completely eliminates the risk of missing a daily pill. Since consistent adherence is the most important factor for ensuring the effectiveness of oral PrEP, the injectable method provides continuous and stable protection. It can therefore be considered one of the most reliable HIV prevention methods available today.

Who can get it and is it covered in Quebec?

Injectable PrEP, like oral PrEP, is intended for people who are at substantial risk of contracting HIV and who have a negative screening test.

Regarding coverage, injectable PrEP is covered by RAMQ (the public plan) and all private insurance plans in Quebec. As with oral PrEP, the final cost to you depends on your specific coverage, and financial support programs from the manufacturer are available to help reduce or completely eliminate this cost. This is why many people say they receive PrEP "for free."

Is it the right option for you?

Despite its effectiveness, injectable PrEP is not automatically suitable for everyone. It is a very personal choice. Here are a few points to consider:

• The appointment schedule: Are you comfortable with the idea of a clinic or pharmacy appointment every two months to receive your injection?
• Fear of needles: Although the injection is quick, it is still an intramuscular injection. This is an important factor for some people.
• Your lifestyle: If you travel very frequently or for long periods, the logistics of a fixed appointment can be more complex than carrying pills with you.
• The nature of the treatment: The medication stays in the body for a long time. This means that a side effect (like tenderness at the injection site) can also last longer than if one were to simply stop taking a pill.

In summary, injectable PrEP is a major advancement that simplifies life for many people. A frank discussion with one of our pharmacists is the best way to weigh the pros and cons and to determine if this option fits your reality.

The answer is simple: by following your treatment rigorously.

The effectiveness of PrEP is not a matter of luck, but of science. Maintaining a sufficient concentration of the medication in your body is the only way to achieve the greater than 99% effectiveness demonstrated in studies.

What does that mean in practice?

It means following the protocol that was prescribed for you, without compromise.

• For daily oral PrEP: Take one pill, every day, ideally at the same time. Integrate it into a routine (waking up, meals, bedtime) to make it automatic. Maximum protection is reached 7 days after starting daily PrEP.
• For on-demand oral PrEP: Strict adherence to the 2-1-1 schedule is non-negotiable. Each dose plays a specific role in ensuring your protection.
• For injectable PrEP: Maximum protection is reached 7 days after the first injection. You must then attend all your appointments (every 2 months) to maintain it.

What to do if you have trouble with adherence?

Maintaining a perfect routine can be challenging. If you frequently forget to take your medication, the important thing is to talk about it.

• Discuss it with us: Your pharmacist is your ally. We can find practical solutions with you, such as reminder apps or pill organizers.
• Consider an alternative: If missed doses are frequent, injectable PrEP might be a better option for you, as it completely eliminates this risk.

Your regular follow-up appointments are the ideal time to discuss your adherence to the treatment and adjust the strategy as needed. This is an essential dialogue for your safety.

Doxy-PEP is a prevention strategy that uses an antibiotic, doxycycline, after a risky sexual encounter to reduce the chances of contracting certain bacterial STIs.

It is crucial to understand that Doxy-PEP does not protect against HIV or other viral STIs like herpes or HPV.

How does it work?

The principle is simple: it involves taking a single dose of 200 mg of doxycycline as soon as possible after condomless sex, ideally within 24 hours and no later than 72 hours. You can think of it as the "morning-after pill" for bacterial STIs.

How effective is it?

Major scientific studies have shown very encouraging effectiveness. Among the most studied populations (men who have sex with men and transgender women), Doxy-PEP reduces the risk of contracting:

• Syphilis: by about 70% to 90%
• Chlamydia: by about 70% to 80%
• Gonorrhea: a more modest reduction (about 0% to 50%), as more and more strains of gonorrhea are resistant to doxycycline.

Points to consider for an informed choice

• The use of antibiotics: Public health authorities closely monitor the use of antibiotics. That's why Doxy-PEP is offered on a targeted basis, after a discussion about the clear benefits for you versus this collective issue.
• An approach based on current data: For now, research has shown very clear benefits for certain populations (MSM and transgender women). Our recommendation is always based on the most solid scientific data.

Who is Doxy-PEP for right now?

This is not a general recommendation for the public. It is an option that is discussed on a case-by-case basis, primarily for people who are already on PrEP for HIV (or who are living with HIV with an undetectable viral load) and are at high risk of contracting an STI.

The decision to start Doxy-PEP is always made in discussion with your doctor or pharmacist. Make an appointment with our pharmacists to discuss it.

(information up to date in june 2025)

Yes, absolutely. PrEP, whether it is oral or injectable, is covered by drug insurance plans in Quebec.

Whether you are covered by the public plan (RAMQ) or by private insurance, PrEP is included in the coverage.

It is a prevention tool that is recognized and encouraged by public health for anyone at risk of acquiring HIV.

Injectable PrEP is very well-tolerated by the vast majority of people.

When side effects do occur, they are generally mild, temporary, and entirely manageable. Here is what is most often observed.

The main side effect: injection site reactions

This is by far the most common and expected effect. It is normal to experience a local reaction after the injection into the gluteal muscle. These reactions are generally mild to moderate and fade on their own within a few days. The most frequent are:

• Pain or tenderness to the touch
• Redness or mild swelling
• Induration (a small lump or hardened area under the skin)

Most people report that these reactions decrease in intensity after the first few injections.

Other possible side effects

Less often, other effects may be felt, especially in the days following the injection. They are generally short-lived.

• Flu-like symptoms: It is possible to experience fatigue, body aches, headaches, or a low-grade fever.
• Rarer effects: Very few people report dizziness or mild digestive issues.

How to manage these effects

The good news is that most of these effects can be easily alleviated.

• For pain at the injection site: You can apply a cold compress or gently massage the area.
• For other symptoms: Rest is often sufficient. For headaches or fever, you can take an over-the-counter pain reliever like acetaminophen (Tylenol®) or ibuprofen (Advil®), after checking with your pharmacist.

If a side effect seems severe, does not improve after a few days, or worries you, it is important to contact us to discuss it.

Injectable PrEP is very well-tolerated by the vast majority of people.

When side effects do occur, they are generally mild, temporary, and entirely manageable. Here is what is most often observed.

The main side effect: injection site reactions

This is by far the most common and expected effect. It is normal to experience a local reaction after the injection into the gluteal muscle. These reactions are generally mild to moderate and fade on their own within a few days. The most frequent are:

• Pain or tenderness to the touch
• Redness or mild swelling
• Induration (a small lump or hardened area under the skin)

Most people report that these reactions decrease in intensity after the first few injections.

Other possible side effects

Less often, other effects may be felt, especially in the days following the injection. They are generally short-lived.

• Flu-like symptoms: It is possible to experience fatigue, body aches, headaches, or a low-grade fever.
• Rarer effects: Very few people report dizziness or mild digestive issues.

How to manage these effects

The good news is that most of these effects can be easily alleviated.

• For pain at the injection site: You can apply a cold compress or gently massage the area.
• For other symptoms: Rest is often sufficient. For headaches or fever, you can take an over-the-counter pain reliever like acetaminophen (Tylenol®) or ibuprofen (Advil®), after checking with your pharmacist.

If a side effect seems severe, does not improve after a few days, or worries you, it is important to contact us to discuss it.

The injection must be administered in person by a trained health care professionnal, but we coordinate all the logistics for you.

Our role is to make this process as simple and practical as possible. Here are the two main options available to you:

Option 1: A nursing service point near you

We enroll you in the support program offered by the manufacturer of Cabotegravir (Apretude®). A nurse from this program will contact you directly to find the most convenient injection location for you (this could be a CLSC, a partner clinic, etc.). This injection service is always free of charge.

• Simple logistics: Our pharmacy delivers your medication directly to the chosen location, just in time for your appointment.

Option 2: Directly at our pharmacy

We have our own private and comfortable injection room. Our nurse can administer your treatment on-site, with complete discretion.

What to expect on injection day

Each appointment is simple and well-managed. Here is the process:

1. Quick consultation: The healthcare professional will briefly chat with you.
2. HIV test: (if needed) A rapid screening test is performed to confirm your negative status before each injection.
3. The injection: The administration of the medication into the gluteal muscle takes only a moment.
4. Observation period: It is recommended to remain on-site for about 15 minutes as a precaution.

Regular follow-up is essential to use PrEP safely.

It is a comprehensive prevention program that goes beyond simply taking a medication. Here is what the typical follow-up looks like.

The rhythm: a "check-up" every 3 months

In practice, this means about 4 follow-up appointments per year. Each quarterly follow-up includes:

1. A follow-up consultation

• When: Every 3 months, in person or by phone or with our online platform.
• Why: To review your treatment, discuss your tolerance, answer your questions, and offer you sexual health prevention advice.

2. Regular screenings

• HIV test: Mandatory before each renewal (ideally every 3 months) to confirm your negative status.
• Other STI screenings: Recommended every 3 to 6 months, even without symptoms, to quickly detect and treat any infection.

3. Health monitoring

• For oral PrEP: A blood and/or urine test to check your kidney function is done a few weeks or months after starting, and then about 2 to 4 times a year if everything is normal.

Simple and accessible follow-up

As part of our online clinic, the "consultation" part of this follow-up is done remotely. For the lab work, we send you a requisition so you can get it done at a lab near you. We can help you find a local resource for the tests, if needed.

This regular follow-up is an important commitment, but it allows you to take charge of your overall sexual health, far beyond just preventing HIV.

Modern sexual health relies on combined prevention.

The idea is that there is no single magic bullet, but rather a set of tools that you can combine to create the strategy that perfectly fits your life and your needs. Here are the main tools at your disposal:

The Condom: the "all-in-one" protection

The condom (male or female) remains the only tool that protects against HIV, most other STIs, and unwanted pregnancies all at once.

PrEP: the continuous prevention of HIV

Pre-Exposure Prophylaxis (PrEP) involves taking a medication continuously to prevent HIV from establishing itself in the body. It is an extremely effective method for HIV-negative people.

Doxy-PEP: the post-intercourse prevention of bacterial STIs

Doxycycline Post-Exposure Prophylaxis (Doxy-PEP) involves taking an antibiotic after a risky sexual encounter to reduce the chances of contracting syphilis and chlamydia. It has no effect on HIV.

PEP (or PPE): the emergency prevention of HIV

Post-Exposure Prophylaxis (PEP) is a 28-day course of antiretroviral treatment to be started as soon as possible after a high-risk situation. It is an emergency solution for people who are not on PrEP.

TasP / U=U: treatment as prevention

This is the principle that a person living with HIV who is on effective treatment and has an Undetectable viral load cannot transmit the virus (U=U, or I=I in French). It is a major HIV prevention strategy.

Vaccination: the long-term prevention

Vaccination protects you long-term against several infections. Consider checking if you are up to date for Mpox (monkeypox), hepatitis A and B, and HPV (Gardasil®9).

Regular screening and communication

Getting tested regularly (every 3 months) and communicating openly with your partners are the foundation of a healthy sex life.

In summary, the best strategy is the one you build by choosing the tools that adapt to your life.

The short answer is: for maximum protection, yes. But the realistic answer is: it depends on what you want to prevent and your comfort level with risk.

Let's break that down.

Each tool has its role

You should see PrEP and condoms as two different tools with distinct functions:

• PrEP: This is your extremely reliable protection against HIV, and only HIV.
• The Condom: This is your protection against most other STIs (syphilis, gonorrhea, chlamydia) AND against HIV, in addition to being a form of contraception.

Ideally, using them together offers the most complete protection possible.

Your personal strategy

Many people choose PrEP precisely because consistent condom use is difficult. The final decision is yours and depends on your risk tolerance and communication with your partners.

If you choose not to use condoms consistently, the "trade-off" to stay healthy is to be extremely rigorous about your STI management strategy:

• Regular screening: Your 3-month follow-ups are non-negotiable. They are there to quickly screen for and treat any new infection.
• Discussion with partners: Open communication about screening and status remains essential.
• Doxy-PEP: For some, Doxy-PEP can be an option to discuss to reduce the risk of bacterial STIs.

To see Doxy-PEP as a simple "add-on" to PrEP is to only see part of the picture.

In reality, their combination represents a much more complete and proactive approach to sexual health, with a dual impact: for you, and for the community.

A dual mission: protecting yourself and protecting others

• For you: Using Doxy-PEP in addition to PrEP means regaining control and significantly reducing the burden of bacterial STIs, which can be a source of stress, repeated treatments, and discomfort.
• For the community: It is also a public health gesture. By treating potential infections at the source, you help reduce the total number of active infections in the population and curb the rise in STI rates.

PrEP: the foundation of HIV prevention

It is essential to understand that Doxy-PEP never replaces PrEP. If your sexual practices warrant the use of Doxy-PEP, it means a risk of HIV exposure exists. For an HIV-negative person, PrEP must therefore absolutely be part of the overall prevention strategy.

Who is this combined approach for?

A health strategy must be based on solid scientific evidence. Currently, the clinical studies that have demonstrated the greatest benefits of Doxy-PEP have done so within a specific group.

This approach is therefore discussed on a case-by-case basis and is primarily intended for gay men, bisexual men, and other men who have sex with men (MSM). It is in this group that studies have proven that Doxy-PEP can very significantly reduce recurring bacterial infections.

This includes MSM who are:

• Either PrEP users to prevent HIV.
• Or people living with HIV (PLWHIV) on effective treatment (undetectable viral load, U=U).

Yes, and this ability is at the heart of our service to offer you simple and fast access to PrEP.

Access to PrEP prescriptions by pharmacists in Quebec is evolving. Here are the two models that make this possible:

Our current model: collaboration via a collective prescription

Currently, our pharmacy operates with a collective prescription. This is a care protocol that we have developed in close partnership with a doctor specializing in sexual health.

This protocol recognizes our expertise and formally authorizes us to perform the assessment, initiation, and follow-up for PrEP, under their authorization. It is a proven collaborative model that greatly facilitates access to PrEP.

The near future: professional autonomy with Bill 67

Very soon, the role of pharmacists will be even greater thanks to Bill 67, which modernizes access to care in Quebec.

This law will give qualified pharmacists the right to prescribe PrEP autonomously, without a collective ordinance. Of course, this right comes with responsibilities: only pharmacists who have completed the appropriate training and possess the required expertise will be able to do so, in order to always guarantee safe, personalized, and human support.

Whether through our current model or with future autonomy, our commitment remains the same: to eliminate barriers so you can access PrEP easily.

Our in-person services are offered at the Pharmacie du Village, located at:

800 Ontario Street East, Montreal, QC H2L 1N9

At the corner of St-Hubert Street, a few minutes' walk from the Berri-UQAM and Sherbrooke metro stations. We are at the junction of three iconic neighborhoods: The Village, the Quartier Latin, and the Plateau-Mont-Royal.

The space has been designed to offer you a confidential, respectful, and non-judgmental welcome. Whether you're just passing through or from the neighborhood, you can meet with a pharmacist trained in sexual health and PrEP in an accessible and inclusive setting.

Vaccination is a pillar of sexual health, just like screening, PrEP, or condoms.

Getting vaccinated means protecting yourself long-term against several infections that can have serious consequences. Here is an overview of the key vaccines to discuss with our team, including information on their free availability in Quebec through the Quebec Immunization Program (PIQ).

HPV Vaccination (Gardasil® 9)

• What does it protect against? The Human Papillomavirus (HPV), which is responsible for genital warts (condylomas) and nearly all cases of cervical and anal cancer, as well as the majority of throat and penile cancers.
• How is it transmitted? Very easily, through simple intimate skin-to-skin contact.
• Who can get it for free (PIQ)? Youth in the 4th grade, MSM aged 26 and under, and immunocompromised individuals.
• Why is it important? It is a direct and highly effective protection against several common types of cancer and against genital warts.

Hepatitis A and B Vaccination (often as the combined Twinrix® vaccine)

• What do they protect against? Serious viral infections of the liver. Hepatitis B can become chronic and lead to cirrhosis or liver cancer.
• How are they transmitted? Hepatitis A via the fecal-oral route (including sexual contact); Hepatitis B via bodily fluids and blood.
• Who can get them for free (PIQ)? Hepatitis B: everyone with a RAMQ card. Hepatitis A: Several at-risk groups, including MSM and people who inject drugs.
• Why is it important? It's the best way to protect your liver's health.

Mpox (monkeypox) Vaccination

• What does it protect against? The Mpox virus, which causes often painful skin rashes and severe fatigue.
• How is it transmitted? Through close, direct contact with the skin lesions of an infected person.
• Who can get it for free (PIQ)? Those most at risk, including MSM and people with multiple partners. This vaccine in only available at public centers.
• Why is it important? To avoid a very uncomfortable, sometimes dangerous illness that can leave scars.

The Menveo® vaccine and gonorrhea prevention

• The sexual health "bonus": Officially, this vaccine protects against meningitis, but studies have shown it offers moderate cross-protection (about 30-40%) against gonorrhea.
• Who can get it for free (PIQ)? Only for individuals at high risk for meningitis, not for gonorrhea prevention.
• Why is it important to talk about? With the rise of antibiotic-resistant gonorrhea, this additional protection can be relevant. It is a case-by-case discussion.

An investment in your health

Even if you are not eligible for free coverage, most private insurance plans reimburse a large portion of the cost of vaccines. Consider vaccination a direct investment in your long-term health.

This is an excellent question because even though the acronyms are similar, their roles are complete opposites.

The best way to see the difference is to compare the regular birth control pill to the morning-after pill.

PrEP: your planned, preventive protection

Think of PrEP as the "birth control pill" for HIV.

• Its role: It is a proactive protection that you take continuously before a potential exposure to HIV.
• How it's taken: On a regular basis (a daily pill or an injection every two months).
• Who it's for: For HIV-negative people who want continuous protection against HIV.

PEP (or PPE): your emergency solution after a risk

Think of PEP as the "morning-after pill" for HIV.

• Its role: It is an emergency treatment that is taken after a high-risk situation.
• How it's taken: It is a full 28-day course of treatment that must be started within a maximum of 72 hours after the risk.
• Who it's for: For HIV-negative people who have experienced a potential exposure and were not on PrEP.

In summary:

• PrEP = PRE-exposure. It is a continuous preventive strategy.
• PEP = POST-exposure. It is a one-time emergency treatment.

PEP is for any HIV-negative person who has experienced a high-risk situation for HIV exposure within the last 72 hours.

If you think you are in this situation, the first thing to do is to consult a healthcare professional without any delay. A professional assessment is always necessary to determine if PEP is the right solution for you.

What types of risks can justify PEP?

The assessment will focus on exposures that present a significant risk of HIV transmission. The most common examples include:

• Sexual exposures: Anal or vaginal intercourse without a condom, a condom breaking, or sexual assault.
• Blood-related exposures: Sharing injection material or an accidental injury with a potentially contaminated object.

Risk assessment: an essential step

Before prescribing PEP, the healthcare professional must evaluate the actual level of risk. This confidential discussion takes into account factors like the type of exposure, the status of the source partner (if known, and if their viral load is undetectable, U=U), and your own HIV status, confirmed by a rapid test.

In which cases is PEP generally not indicated?

• If you are already on PrEP with good adherence.
• If the exposure occurred more than 72 hours ago.
• If the risk is judged to be very low or nil after assessment (e.g., oral sex).
• If you are already living with HIV (a full treatment regimen is needed then, not PEP).

The key message is: when in doubt, consult immediately. It is better to have a consultation for nothing than to leave a risk unmanaged.

Yes, it is still recommended and is even more important.

Screening every 3 months allows you to:

1. Ensure the strategy is working well for you, as Doxy-PEP is not 100% effective.
2. Quickly screen for infections not covered by Doxy-PEP (like certain strains of gonorrhea and HIV).
3. Monitor your overall sexual health.

Doxy-PEP is a tool, not an exemption from follow-up.

When used correctly, PEP is an extremely effective emergency intervention to prevent HIV infection.

Its success relies mainly on two golden rules: speed and rigor.

Rule #1: Speed - Act as quickly as possible

This is the most critical factor. PEP must be started as soon as possible after the risk, and no later than 72 hours after. Do not wait. The faster you act, the greater the chances of success.

Rule #2: Rigor - Follow the 28-day treatment

PEP is not a single dose. It is a complete course of antiretroviral treatment that you must take every day, for 28 days without interruption. Missing doses seriously compromises the treatment's effectiveness.

The effectiveness of today's treatments

You may have heard the effectiveness figure of "over 80%." This statistic dates back to the 1990s and is based on a single medication (AZT), which was much less potent than current options.

Today, PEP uses combinations of modern medications. The medical consensus is clear: the effectiveness of modern PEP is much higher and approaches 99% when the treatment is started quickly and taken rigorously. Cases of failure are exceptionally rare.

Non, absolument pas. La Doxy-PEP ne protège que contre certaines ITS bactériennes (principalement syphilis et chlamydia) et n'a aucun effet sur le VIH, l'herpès, les VPH (condylomes) ou les hépatites. Le condom demeure le seul outil offrant une protection à large spectre contre la majorité des ITS.

C'est une question de résistance. Au fil des ans, de nombreuses souches de la bactérie de la gonorrhée ont évolué et sont devenues résistantes à l'action de la doxycycline. Le médicament n'est donc plus aussi efficace pour l'éliminer. C'est pourquoi la Doxy-PEP reste un excellent outil pour la syphilis et la chlamydia, mais une protection seulement partielle pour la gonorrhée.

Yes, PEP is an effective strategy for preventing HIV after different types of high-risk exposure, whether sexual or blood-related.

However, the fact that PEP works does not mean it is necessary or recommended after every situation. A professional assessment is always crucial to determine if the risk of transmission justifies the treatment.

The main types of exposure where PEP is an effective option

• Sexual exposures: Highly effective after anal or vaginal intercourse without a condom, or in case of a condom accident (breaking, slipping).
• Sharing of injection equipment: A key intervention in cases of sharing syringes or needles.
• Occupational exposures: Used by healthcare personnel in case of a needlestick injury or blood contact.

Why is risk assessment so important?

Even for a risky exposure, a discussion with a healthcare professional is essential because:

• The level of risk varies: Receptive anal sex carries a much higher risk than other types of contact.
• The status of the source partner is key: If your partner is living with HIV but has an undetectable viral load (U=U, Undetectable = Untransmittable), the risk is zero and PEP is not necessary.
• Some contacts pose no risk: HIV is not transmitted through saliva or skin contact without an open wound. PEP is not indicated in these cases.

In short, PEP is a powerful tool, but its prescription always depends on a rigorous assessment of the actual risk. When in doubt, always consult.

Our online clinic aims to make PrEP accessible everywhere in Quebec, but we recognize the importance of having access to local services.

For a complete list of clinics, pharmacies, and community groups offering PrEP services in your region, the best resource is the website MaPrEP.org.

It is an up-to-date directory that allows you to find help and care near you.

No, absolutely not. This is one of the most persistent misconceptions about PrEP.

Historically, the first studies and promotional campaigns heavily targeted gay men, bisexual men, and other men who have sex with men (MSM), as they represented (and still represent) one of the populations most affected by the HIV epidemic. This is why the association is so strong in people's minds. But the reality is much broader.

The only real criterion: risk, not gender or orientation

PrEP is for ANYONE who is HIV-negative and at substantial risk of acquiring HIV, regardless of their gender, sexual orientation, origin, or lifestyle. The virus does not discriminate, and neither does prevention.

Risk can apply to many people, including:

• Women (cisgender and transgender) and non-binary people, especially if they have partners whose HIV status is unknown.
• People who inject drugs (PWID) and who might share equipment.
• Sex workers.
• People with multiple partners or partners who themselves have multiple partners.

Equitable access: our commitment

We recognize that for many people, accessing preventive healthcare like PrEP can be fraught with obstacles. Stigma, language or cultural barriers, a legitimate mistrust of the healthcare system, or simply a lack of targeted information are realities.

This is particularly true for certain communities, including Indigenous communities, Black communities, racialized people, and migrants, who face systemic health inequalities and therefore sometimes increased risks.

Our role, as front-line healthcare professionals, is to work to break down these barriers. We are committed to offering a safe, confidential, and non-judgmental space where every person, whatever their reality, can discuss their sexual health and access PrEP if it is the right option for them.

Yes, in Quebec, PrEP is covered for anyone who has drug insurance, whether public or private.

However, the level of coverage and the reimbursed options can vary. Here is what you need to know.

The principle of coverage in Quebec

The law requires all insurance plans to cover at least the most standard PrEP options.

• Generic oral PrEP (equivalent to Truvada®): Always covered by all plans.
• Oral PrEP with Descovy®: Covered by most private insurance plans, but access is limited with RAMQ.
• Injectable PrEP (Apretude®): Covered by both RAMQ and private plans.

RAMQ, private insurance, and other programs

• With RAMQ: Your cost is predictable. It is limited by your monthly co-payment and deductible, until you reach the maximum annual cap set by the government.
• With private insurance: Coverage varies greatly. A personalized quote is essential to know the exact cost.
• For eligible First Nations and Inuit people: PrEP is covered by the federal Non-Insured Health Benefits (NIHB) program.
• For asylum seekers and refugees: PrEP is generally covered by the Interim Federal Health Program (IFHP) pending eligibility for RAMQ.

What if my out-of-pocket cost is too high?

This is where the financial support programs offered by the drug manufacturers come in. In many cases, these programs cover the portion of the cost that is not paid by your insurance, which can reduce your share to a very small amount, or even to zero.

The system can seem complex, but our job is to help you see clearly. Contact us with your insurance details. We can give you the exact cost for each option and help you enroll in support programs to prevent financial barriers from blocking your access to PrEP.

No, absolutely not. You should see our service as a specialized resource that works hand-in-hand with your doctor.

Our goal is not to replace, but to collaborate for your overall well-being.

Our role: simplified access to a specific service

Our clinic offers you fast, simple, and direct access to PrEP and all the services that surround it (screening, follow-up, etc.). By focusing on this specific aspect of your health, we manage the rigorous follow-up that PrEP requires, saving you from waiting room delays.

Your doctor's role: the overall vision of your health

Your family doctor remains the most important resource for your overall health. They follow your other medical conditions and manage any health problem not directly related to your PrEP follow-up.

Teamwork to better serve you

We work in partnership. With your consent, we keep your doctor informed of the follow-ups and treatments we initiate, thus ensuring perfect continuity of care.

In practice, you continue to see your doctor for your annual check-ups or other health needs, and you consult us for your HIV prevention. It's a team effort, designed so that you get the best care at the right time.

No, PrEP is considered a very safe treatment and is very well-tolerated by the vast majority of people.

The benefit-to-risk ratio is overwhelmingly in favor of taking PrEP for people at risk. The benefit of preventing HIV far outweighs the risks of side effects, which are rare and well-managed with proper follow-up.

Why does this question come up often?

The concern mainly stems from discussions around the first generation of oral PrEP, tenofovir disoproxil fumarate (TDF), which is found in Truvada® and its generics. Studies have shown that TDF can, in rare cases, have an impact on the kidneys and bones.

• On the kidneys: It can cause a slight decrease in kidney filtration, which is reversible upon discontinuation, generally minor, and not clinically significant in healthy individuals.
• On the bones: It can be associated with a small decrease in bone mineral density (about 1-2%), which is rarely problematic, often reversible, and below the threshold for increased fracture risk.

It is important to contextualize this risk. It is primarily a concern for older individuals or those with pre-existing health issues (kidney disease, poorly controlled diabetes, bone fragility, or hypertension). For healthy people, the rigorous follow-up we provide, including monitoring your kidney function, makes using PrEP very safe.

The newer PrEP options: even fewer risks

Science has advanced. Newer PrEP options have been specifically developed to minimize these risks:

• Oral PrEP with TAF (Descovy®): This newer version of tenofovir (tenofovir alafenamide) is not associated with particular risks to the kidneys or bones.
• Injectable PrEP (Apretude®): Injectable cabotegravir works differently and has no known impact on kidney function or bone density.

In summary, not only is PrEP very safe, but there are now several options, allowing us to choose with you the one that is the most suitable and safest for your body and your situation.

That's an excellent question. The short answer is: the risk is lower, but it is far from zero. The decision to take PrEP, therefore, depends on your overall situation and your personal comfort with that risk.

Let's break that down together.

Understanding the risk for the "top" partner

It is scientifically proven that the risk of acquiring HIV is significantly lower for the insertive partner ("top") than for the receptive partner ("bottom") during condomless anal sex.

However, a low risk is not a zero risk. Transmission is possible, although rare, through the opening of the urethra on the penis, especially if small cuts or another sexually transmitted infection (STI) are present, which could create an entry point for the virus.

The decision is yours and depends on several factors

The choice to take PrEP is not based solely on a sexual role, but on an overall assessment of your situation. Here are some questions to ask yourself:

• Do you have multiple partners or partners whose HIV status you don't know?
• Do your partners have other partners?
• Are you always exclusively a "top," or could that change?

Some people choose to take PrEP even if they are exclusively tops for complete peace of mind.

The benefits of the "PrEP program" beyond the pill

It's also helpful to see PrEP not just as a medication, but as access to a comprehensive sexual health program. The regular follow-up that comes with PrEP (HIV and STI screenings every 3 months) is one of the best ways to proactively take charge of your sexual health, regardless of your specific HIV risk level.

The best approach: an informed discussion

The final decision is yours. The most important thing is to have a frank and non-judgmental discussion with one of our pharmacists. Together, we can analyze your personal situation to help you make the most informed decision for your health and your peace of mind.

Above all, it is a confidential and non-judgmental discussion to determine the best prevention strategy with you.

Our goal is to listen to you, understand your reality, and give you all the necessary information so you can make an informed decision. This is not an interrogation.

Topics we will discuss together

• Your general health and medical history.
• Your sex life and practices, to properly assess your risk level and needs.
• Your questions and concerns about PrEP.

What you get at the end

• Clear answers to all your questions.
• An overview of the different PrEP options (daily oral, on-demand, injectable).
• The requisition for the necessary lab tests before starting.

You will leave with a clear and personalized plan for the next steps.

Once your tests are done, we can quickly deliver your medication to your home for free.

Les deux options sont extrêmement efficaces pour prévenir le VIH. La différence principale est la molécule de ténofovir utilisée, ce qui influence leur profil de sécurité et pour qui elles sont recommandées.

TDF/FTC (Truvada® et ses génériques)

C'est la version originale, la plus étudiée et la plus prescrite de la PrEP.

• Sécurité : Elle est très sécuritaire pour la grande majorité des gens. Son impact potentiel sur les reins et les os, bien que très faible chez les personnes en bonne santé, est surveillé par précaution.
• Pour qui : C'est la seule option validée par les études pour les rapports vaginaux et pour la PrEP "à la demande".

TAF/FTC (Descovy®)

C'est une version plus récente du ténofovir, conçue pour avoir un impact encore plus faible sur les reins et les os.

• Sécurité : Offre un profil de sécurité supérieur pour les reins et les os.
• Pour qui : Son utilisation est actuellement recommandée pour la prévention du VIH lors de rapports anaux.

Comment choisir?

Le choix se fait avec votre professionnel·le de la santé en fonction de votre type de rapports sexuels, de votre état de santé (notamment rénal et osseux), et de votre couverture d'assurance. Les deux sont d'excellents outils de prévention.

Oui, la PrEP est considérée comme sécuritaire et est recommandée pour les femmes et personnes enceintes ou qui essaient de concevoir et qui sont à risque de contracter le VIH.

Protéger la mère est la meilleure façon de protéger le bébé.

Quelle option est recommandée?

La formulation la plus étudiée et recommandée durant la grossesse et l'allaitement est le TDF/FTC (Truvada® et ses génériques). Les données accumulées depuis des années n'ont montré aucun risque accru d'anomalies congénitales.

Pourquoi est-ce important?

Prendre la PrEP durant la grossesse protège non seulement la mère, mais empêche aussi une potentielle transmission du VIH au bébé durant la grossesse, l'accouchement ou l'allaitement.

La décision de commencer ou de continuer la PrEP est une discussion importante à avoir avec votre équipe de soins pour assurer un suivi adapté et sécuritaire pour vous et votre bébé.