PrEP clinics at l'Actuel. Call 514 524 1001.

PrEP clinics are open to people who wish to take PrEP (pre-exposure prophylaxis) or are considering taking it.

See here for 11 questions and answers on PrEP

When you make an appointment at a PrEP clinic, you will meet a doctor and a nurse, who will each take the time needed to:

• Assess your level of risk.
• Determine whether or not you should take prep.
• Explain PrEP and how to use it (continuous or occasional).
• Answer all your questions.

It is important to do a thorough assessment, case by case, to determine if PrEP is indicated.

People who are likely to benefit from PrEP

• Men who have sex with men (MSM)*
• People whose sexual partner is infected with HIV and has not been treated
• Intravenous drug users who do not always use sterilized needles and syringes

*HIV infection remains a major concern in Quebec’s gay community. Between 2009 and 2013, the number of new HIV diagnoses grew by 17%. Among males, three-quarters (76.4%) of new diagnoses are in men who have sex with men (MSM). In addition, the trend in new diagnoses indicates an increase among MSMs under age 35.

Before you take PrEP

PrEP is intended for HIV-negative individuals who are at high risk of contracting HIV and wish to reduce this risk.

Before you begin taking PrEP, we need to:

• Screen you to determine your HIV status.
• Do a blood test, especially to ensure that there are no medical contraindications.
• Screen you for other sexually transmitted infections (STIs).

While you are taking PrEP

The treatment used in PrEP is Truvada, a pill that you take once a day. This medication contains two antiretroviral drugs that block the replication cycle of HIV and prevent it from multiplying in the blood and infecting the body.

The treatment may cause mild side effects, such as nausea or headaches, especially at the beginning. Most side effects are short-lived. It is important to discuss this issue with your doctor.

In rare cases, other more serious side effects may occur when you take PrEP. For this reason, we need to do blood tests before and after you begin treatment.

People who use PrEP should be monitored every three months, so that we can:

• Do blood tests.
• Screen patients for HIV and STIs.
• Asses the level of adherence to the treatment.

The effectiveness of PrEP

Recent studies have shown that PrEP reduces the risk of HIV infection by 92% if the patient adheres strictly to the treatment. The more treatment is followed to the letter, the more effective PrEP is.

PrEP is not 100% effective, does not protect against other STIs and does not replace the condom. This preventive treatment must be combined with other prevention methods, such as using a condom and getting tested regularly.

PrEP is part of a comprehensive approach to prevention that limits the risk of HIV infection based on your level of exposure.

Commitment of l'Actuel

At Clinique médicale l’Actuel, we have been prescribing PrEP since 2011.

We believe that PrEP is not yet sufficiently used. It is therefore important to inform the communities most at risk of the existence and benefits of this new prevention strategy, and to make it available to all who need it.

We have developed a monitoring protocol for patients taking PrEP. This close supervision involves regular counselling in which we advise patients to encourage their partners to get tested, remind them that PrEP does not work 100% of the time, and inform them that they should combine the treatment with other means of protection.

Our mission is to make PrEP available to as many people as possible. It is part of a truly effective combination prevention strategy that includes regular screening, condom use, PrEP, PEP (post-exposure prophylaxis) and the promotion of safe behaviour.

We are convinced that by implementing these integrated prevention strategies, we can reduce the rate of HIV infection.

“The challenges ahead of us are formidable. We should subscribe to and support the principle that all populations have a right to effective HIV prevention and treatment. Now that PrEP has shown that it works, it seems that extending access to PrEP is not only a matter of public health policy, but an imperative human right.” — Françoise Barré-Sinoussi, Nobel Prize in Medicine, 2008