Why We Need To Work On Making PrEP More Accessible

Please note: this post discusses PrEP in Manitoba, Canada. What may be discussed here may not apply to you if you live elsewhere.

If you’re one of the at-risk groups for contracting HIV (human immunodeficiency virus), then you’ve probably heard of something called PrEP (Pre-Exposure Prophylaxis).

Before we dive into what exactly PrEP is, let’s talk about who it can benefit:

According to HIV.gov, PrEP may benefit if you if you are HIV-negative and any one of the following apply to you:

You are a gay/bisexual man, and you:

• have an HIV-positive partner
• have multiple partners, a partner with multiple partners, or a partner whose HIV status is unknown–and you also:
  • have anal sex without a condom, or
  • recently had a sexually transmitted infection (STI)

You are a heterosexual male or female, and you:

• have an HIV-positive partner
• have multiple partners, a partner with multiple partners, or a partner whose HIV status is unknown–and you also:
  • don’t always use a condom for sex with people who inject drugs, or
  • don’t always use a condom for sex with bisexual men

You inject drugs, and you:

• share needles or equipment to inject drugs
• are at risk for getting HIV from sex

As you can clearly tell, PrEP isn’t just for men who identify as gay or bisexual. While HIV more commonly affects this particular group, we shouldn’t be singled out. This means PrEP can be used by so many people who can benefit from it — so why do we make it so inaccessible?

Before I continue, let’s break down what exactly PrEP is:

PrEP is an HIV prevention method, in which people who are HIV-negative take HIV medicine daily to prevent contracting the virus. If you are in one of the at-risk groups I listed above, PrEP can significantly reduce your chance of contracting HIV by 99%.

99% sounds pretty great, doesn’t it? I agree.

Now here’s the problem: do you have an extra $250-$1000 a month to shell out?

If you answered yes, then congratulations! Go get yourself some PrEP.

If you’re like me, and you answered no, then that’s exactly why the inaccessibility of PrEP is such a huge problem.

Tenofovir/Emtricitabine (Truvada), which is the most common brand used for PrEP, is not an eligible benefit covered under Manitoba Pharmacare.

But guess what?

Manitoba is the only province in Canada that doesn’t provide coverage for PrEP.

If that doesn’t upset you, then quite frankly, I don’t know what will.

Unless you have a third-party or private insurance company who may offer coverage for PrEP, even then, it’s not a guarantee.

So, I ask this question again: why are we making PrEP inaccessible for Manitobans who may need it the most?

As a province, we need to do better, and we need to take care of our community.

And taking care of our community doesn’t mean picking and choosing who we think deserves to live, and who we think deserves to die.

Let’s take this into consideration: In 2019, there were 121 new cases of HIV in Manitoba.

That may seem like a low number to you, but that’s because you don’t have HIV.

Those are 121 people who could have had a chance at still being HIV-negative today.

But now? It’s something they have to live with for the rest of their life.

As a gay man, I don’t feel comfortable having sex with a stranger, because how do I know if they’re HIV-positive? Sure, they can say no. But when was their last test? Do they have proof of being HIV-negative?

It sure sounds a little weird to ask someone for their STI panel before you have sex with them, doesn’t it?

We can take that worry away by making PrEP covered under Manitoba Pharmacare.

But is anyone putting in the work to make it more accessible?

I believe that Manitoba should step up and cover PrEP under their provincial healthcare plan. If we can save even a few lives every single year, then those are still live’s worth saving.

Even though you may not know someone living with HIV, those who do are someone’s friend, brother, sister, mother, father, grandmother, or grandfather.

You aren’t safe from HIV either.

Please use your voice to make PrEP more accessible.

If you want to learn more about PrEP, here are some helpful resources below:

Nine Circles Community Health Centre – PrEP information for healthcare providers

Manitoba 2019 HIV statistical update

CATIE (Canadian AIDS Treatment Information Exchange) – PrEP access and coverage