PrEP
PrEP (pre-exposure prophylaxis) is a highly effective strategy for preventing HIV.
It involves HIV-negative individuals taking anti-HIV medication before sexual intercourse to reduce the risk of HIV infection. Read on to see whether this could be a good strategy for you!
What is PrEP?
PrEP is a medication that is taken before sexual intercourse. It only prevents HIV infection; it does not protect against other STBBIs.
PrEP is available in tablet (pill) or injectable (liquid) form.
Regardless of the type of PrEP, it must be taken correctly to be effective. Scientific studies have shown that PrEP is effective in preventing HIV infection only if taken as prescribed by your doctor.
There are two ways to take PrEP tablets:
- Continuously. This is the most common way. It means taking one pill at the same time every day.
- Intermittently or “on demand.” You take PrEP before and after sex for a few days. You take two pills 2 to 24 hours before high-risk exposure to HIV and one pill a day for up to 48 hours after exposure.
For injectable PrEP, the formula currently approved in Canada is one injection every two months, for a total of six injections per year. During the first month, you may take PrEP in pill form to confirm that you tolerate the medication well. After that, if you tolerate it well, you will receive one injection every two months.
A new form of PrEP requires only two injections per year, or one every six months! It has already been approved in the United States and Europe, and we are awaiting approval in Canada.
What is a high risk of HIV exposure?
A high risk of HIV exposure occurs when you have anal sex without a condom:
- with a partner whose HIV status is unknown
- with an HIV-positive partner with an unknown or high viral load (above 200 copies per milliliter of blood)
So if you have sex with someone living with HIV who is undetectable, PrEP is not necessary to protect you from HIV with that person. See the section on viral load for more information. If you have other partners, PrEP may be right for you. In any case, if you are considering PrEP, talk to your doctor to assess whether it is right for you, or read the following section.
Is PrEP a good fit for me?
PrEP may be right for you if:
- You want to reduce your risk of contracting HIV
- You rarely or never use condoms
- You use condoms most of the time, but not always
- You want to protect yourself even when you use drugs
- You want to be able to protect yourself, no matter who you have sex with
If you are considering it, talk to a doctor. Together, you will assess the situation, but keep in mind that doctors should prescribe PrEP to anyone who requests it.
Here are some questions that may help:
- Are you HIV-negative? The doctor will be able to check this with a blood test. This is the standard HIV screening test. You must be HIV-negative to take PrEP.
- Have you had anal sex without a condom in the last six months? In this case, PrEP may be right for you.
- In addition to having had anal sex without a condom in the last six months, does at least one of the following situations apply to you?
- Having used post-exposure prophylaxis (PEP) more than once.
- Having an HIV-positive partner with a high or unknown viral load
- Having sex while using drugs
- Having had two or more sexual partners in the last six months
If you answer yes to any of these questions, PrEP is for you. Consult a doctor to access it. You can use the postal code search tool to find a clinic, or contact your local community organization to find out where to get a referral.
If you speak French, you can take the quiz on the MaPrep.org website of the Portail VIH/sida du Québec to assess whether this method is right for you.
PrEP reduces the risk of HIV infection, but not other STBBIs. To protect yourself from other STBBIs (such as syphilis or gonorrhea), learn about other prevention methods.
Where can I get access to PrEP?
Technically, you can get PrEP from any doctor who agrees to prescribe it. You can also talk to your family doctor if you have one.
Note that doctors should prescribe PrEP to anyone who asks for it. However, not all doctors know how to prescribe it, even though it’s easy. You can consult your local HIV community organization for support or to find out which clinics routinely prescribe PrEP.
To find the organization closest to you, use the zip code search tool.
The MaPrep.org website of the Portail VIH/sida du Québec (French only) allows you to print information for healthcare professionals so you can arrive prepared for your appointment.
Recent changes now allow pharmacists to prescribe PrEP. Negotiations are still ongoing. If you are having difficulty obtaining PrEP in your area, you can contact the Proxim pharmacy in the Village (Montreal), which offers remote consultations and deliveries throughout Quebec.
How much does it cost?
PrEP tablets and injections are covered by public drug insurance plans and group insurance plans.
RAMQ
If you are covered by the Régime de l’assurance maladie du Québec (RAMQ; Quebec Health Insurance Plan) you will have to pay the maximum monthly amount of $102.64 (in 2025). If you are currently taking medication, it will not cost you any more; after the maximum amount, your medication is still free.
Private insurance
Keep in mind: PrEP is not necessarily covered by your private insurer. The amounts payable by people who have group insurance through work or who are covered by a spouse’s or parent’s insurance vary depending on the group insurance policies, so you should check with your insurer. Generally, annual coverage begins on January 1st.
You don’t have insurance?
Without public or private insurance, the monthly cost of daily PrEP tablets is approximately $215 for the generic version and $800 for the brand name version. For bi-monthly injections, the cost is approximately $10,260 per year. These costs are for medication only; they do not include the costs associated with medical appointments and testing.
Learn more
MaPrep.org (French, Portail VIH/sida du Québec)
What is PrEP? (French and English, Portail VIH/sida du Québec)
8 questions about PrEP for guys. (CATIE, 2018)
HIV pre-exposure prophylaxis (PrEP). (CATIE, 2018, updated in 2025)
PrEP. (French, REZO, health and wellness for gay and bisexual men, cis and trans)
Medical monitoring of PrEP
If you are HIV-negative and start PrEP, you will need to see your doctor regularly (every 2, 3, or 4 months, depending on your situation) to:
Side effects
PrEP is generally well tolerated. Some people may experience side effects that usually disappear after a few days or weeks, such as:
If you experience side effects, talk to your doctor. PrEP can also have an impact on your kidneys, liver, or bones while you are taking it. Your doctor will do the necessary follow-ups to ensure that this impact remains minimal.