PrEP still 'underused' in Canada, experts say | AIDS: on the trail of a pandemic

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PrEP still “underused” in Canada, experts say | AIDS: on the trail of a pandemic

PrEP, a combination of antiretrovirals, is exceptionally effective in preventing HIV.

Ten years after its appearance on the market, the preventive HIV drug nicknamed “PrEP” is is quickly popularized in certain segments of the population. Experts believe, however, that there is still much progress to be made to use it to its full potential.

It's one pill a day to prevent contracting HIV: FrancoQueer director Arnaud Baudry's description of pre-exposure prophylaxis, or PrEP, sounds almost too good to be true, but it's hardly true. almost exact.

In men who have sex with men, this preventive treatment is 99% effective.

It allows me to have a more fulfilling sex life, with less anxiety, explains Arnaud Baudry, who has been taking it for several years.

Toronto's Jerome Johnson asked for a prescription for the first time last year.

Taking PrEP has made me calmer. It helped me have sex without fear, he says.

The US regulatory agency, FDA, approved PrEP in 2012. It took four years at Health Canada to do it too.

Everyone wanted it, but it was expensive, remembers Toronto pharmacist Kishan Rana.

It was a few thousand dollars a month initially. The arrival of generic versions on the market, however, quickly brought down costs, and today, two-thirds of Canadians who take them are partially or totally reimbursed by their private insurance.

Programs offering it for free or at a reduced cost have multiplied.

The number of Canadians taking PrEP has quadrupled between 2016 and 2020, according to the public health of Canada. The latest published data indicates that there were 9657 in 2018.

Kishan Rana now works at one of three PrEP clinics in Ontario.

He says between 30 and 50 patients come there every day for sexual health services, 90% of which for PrEP.

Kishan Rana is one of the pharmacists at the PrEP clinic, a specialized service that offers online and in-person support to Ontarians interested in this preventive product.

For the professor of virology at the University of Ottawa Hugues Loemba, this drug has been of tremendous help in the fight against HIV.

I wouldn't say it's revolutionary, but it's not is not far, he says.

However, he believes that there is still a long way to go to exploit this scientific advance to its full potential.

A recent study published in the Journal of the Medical Association Canada concludes that PrEP remains underused in the country.

The authors point out that, since 2016, the majority of efforts to roll out the product have focused on men who have sex with men.

We need to keep the focus on them, but include other groups too, believes Dr. Loemba.

He believes there is a particularly long way to go in getting people who inject drugs to take PrEP.

He also points out that the risks of HIV are also frequently underestimated, especially in some First Nations and immigrant communities.

The director of the Toronto organization African Partnerships Against Aids (APAA), Fanta Ongoïba, says that the drug was not easy to obtain in her community in the early days after its approval.

PEP treatment, which can be taken directly after possible exposure to HIV to reduce the risk of infection, either.

Fanta Ongoïba says the arrival of PrEP in Canada was “good news”, but there is still a long way to go to spread its use.

People are asking [have] the question: is it because I'm not LGBT? Is it because I'm black? Why didn't that doctor believe what I said? […] So it was a bit discouraging. I was thinking if that's how it is, why talk about PREP or PEP in our community if they can't access it?

She is delighted that this is no longer the case.

But if prescriptions are easier to obtain today, Ms. Ongoïba, Kishan Rana and Arnaud Baudry all three emphasize that the cost of the drug remains prohibitive for many people.

In some provinces, including British Columbia and Alberta, it is covered by the public plan, but not in Ontario.

For those who don't have supplemental insurance from their employer and don't qualify for an exemption in the nation's most populous province, the bill is $250 per month .

Why is it a privilege [to have access]? Because it's a privilege, says Arnaud Baudry indignantly.

We still have a long way to go, because the work is not finished. HIV is not completely eradicated, says APAA director.

In 2020, the Public Health Agency of Canada estimated that approximately 62,790 people were living with HIV in the country.

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