PrEP For Women
WHAT IS PrEP?
If you haven’t heard about PrEP before – you are not alone. PrEP is a highly effective medication for the prevention of HIV in people who are HIV-negative. This includes women!
PrEP stands for pre-exposure prophylaxis and is a prescription medication taken daily to reduce the risk of acquiring HIV. If taken consistently, it can reduce the risk by over 90% in women.
Women are sometimes not included in the conversation and we at The PrEP Clinic are proud to be an HIV clinic and pharmacy for EVERYONE. After all, HIV does not discriminate based on age, race, sexual orientation, or gender identity.
In our experience, women are sometimes left out when it even comes to regular sexual health testing too. Through our online service you can not only start PrEP, but also get sexual health tests ordered to be completed at a local lab in your area anywhere in Ontario.
How does it work? How do I take it?
PrEP is a combination of two drugs that fight against HIV known as “antiretrovirals”. They work by preventing HIV from being able to take hold in the body. The medications in PrEP are actually sometimes used as part of HIV treatment regimens as well (but can’t be used alone in treatment, only for prevention).
According to the manufacturer one tablet should be taken every day. Studies have found medication effectiveness depends on how regularly it is taken. Missing doses will make it less effective.
Individuals on daily PrEP will have maximum protection from vaginal sex at 21 days and anal sex at 7 days. The medication needs to be continued once daily as consistency determines the level of effectiveness.
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HOW DOES THIS WORK?
Book an appointment with a FREE online prescriber
They’ll chat with you through our app or your web browser and order lab work.
Once your results come back we will send out your medication via FREE shipping
Just before it is time to refill you will get lab work again and have another quick chat with us before shipping.
Who should go on PrEP?
If you have unprotected sex and don’t always know your partner’s status, PrEP may be right for you. 1 in 7 people living with HIV (PLWH) do not know they have the virus.
Take control and consider PrEP if any of the following apply to you:
- You don’t always use condoms (external or internal) when you have anal or vaginal intercourse and aren’t certain of your partner’s HIV status
- You’ve been diagnosed with a sexually transmitted infection in the last six months
- You’re in a relationship with a partner living with HIV, but they are not undetectable
- You are a person who injects drugs, or you’re in a sexual relationship with a person who injects drugs
PrEP is generally well tolerated and side effects can include stomach upset, headache, or feeling tired. These symptoms usually improve or go away with use. The medications in PrEP have now been studied and taken for 20 years.
Rare potential side effects include impact on your kidney function but your prescriber will monitor this during regular bloodwork. Any changes are generally reversible upon stopping the medication. The other possible side effect is changes in bone mineral density (bone strength). This is generally minor and reversible upon discontinuation.
What If I’m Pregnant, Breastfeeding, or Chestfeeding?
PrEP is safe to take during pregnancy, breastfeeding, or chestfeeding. Ongoing monitoring while on the medication will be recommended.
Can PrEP be taken with contraception (eg. birth control)?
Contraception medication (birth control) is safe to take while on PrEP.
Can PrEP be taking with gender-affirming hormone therapy?
Hormone medication is safe on PrEP as well (eg. estrogen, testosterone blockers). Some data has suggested the levels of one of the medications in PrEP may be lowered while on some hormone medications but is still a highly effective option.
PrEP side effects are generally minor and go away for most people.
How Do I Get On PrEP?
PrEP requires a prescription and a family doctor can prescribe it. The PrEP Clinic connects you with free online prescribers if you do not have a family doctor, your doctor will not prescribe it, or you are seeking additional discretion. As you require regular monitoring and follow-up on PrEP many walk-in clinics will not prescribe it.
The prescriber will discuss with you if PrEP is right for you and order lab work. This includes testing for sexually transmitted infections (STIs), including HIV. They can then prescribe the medication and you will get lab work again before your next prescription refill.
An individual will need to test HIV-negative to be on PrEP. If a person does acquire the virus, PrEP alone is not sufficient to treat HIV and could lead to medication resistance.
Why the PrEP Clinic?
We are the first and only online clinic to provide free PrEP prescribing access to all of Ontario combined with free shipping and pharmacy services. Some pharmacies need to regularly special order PrEP but we always have it in-stock. We are also a designated Safer Space where all are welcome, respected, and accommodated.
Pharmacist-Owner Andrew is an expert on PrEP and HIV medication. In fact, he has even developed education programs for other pharmacists and healthcare professionals to teach them about PrEP. As a result, the pharmacy has distinct protocols to support your understanding and care. Women’s Patient Care Specialist Riya provides additional support to the team.
We work with male and female Nurse Practitioners if you have a preference for your online appointment.
FREE online prescribers and pharmacists are here to help.
Available on the Apple Store & Google Play
How much is it? How do I pay for it?
PrEP is currently covered for some by the public Ontario Drug Benefit Program (ODB) and many private plans. If you are new to PrEP and do not have insurance you can now get the first 3 months FREE through a new program.
PrEP is covered for anyone who is under 25 without private insurance, those on ODSP (disability), OW (Ontario Works), social assistance, and people 65+ through ODB. If you have private insurance and are unsure if PrEP is covered contact us or your insurance company to check. Some private plans require a special authorization form to be filled out by the prescriber which we can help take care of.
If you are without coverage or need additional support, the Ontario government has a free program called Trillium that anyone with an Ontario health card can apply to. This program considers your income and sets a deductible (amount you pay) before it will help cover the rest of your medication costs. We recommend applying right away to this if you do not have coverage as it can take a few weeks to become active. If your private insurance does not cover the medication or does not cover it fully you can also apply to Trillium.
More Info On Trillium (including the application):
We can also email, fax, or mail you a copy of the application. More information on drug coverage is available here.
We can help you navigate coverage options for PrEP.
Myth #1: PrEP encourages everyone to higher risk behavior and increases STIs.
FALSE. Earlier studies that looked at PrEP use had found that PrEP did not significantly change sexual behavior. People who were already at risk just got protection. They also were tested more frequently due to regular monitoring being on PrEP. Some newer studies have suggested a potential increase for some.
Myth #2: PrEP is effective so condoms are not needed anymore.
FALSE. Condom use should still be considered as PrEP does not protect against other STIs besides HIV. PrEP plus condom use does further reduce the risk but is something for each person to determine what is right for themselves.
Myth #3: People who are more sexually active go on PrEP.
FALSE. Besides the fact we should not be disparaging people who have more sex, HIV does not discriminate whether someone has sex once or multiple times. Each sexual interaction is it’s own independent risk.
Myth #4: Nothing can interact with PrEP so no need to worry.
FALSE. It’s always important to check with a pharmacist to see if there are any drug interactions or protentional interactions. An example, is anti-inflammatory medications like Advil (ibuprofen). Regular use of these medications while on PrEP may further increase the risk of the rare side effect affecting the kidneys. Hormone medications that may be taken by some transgender individuals can be combined safely with PrEP. We are available for questions 7 days a week.
Incidence of Gonorrhea and Chlamydia Following Human Immunodeficiency Virus Preexposure Prophylaxis Among Men Who Have Sex With Men: A Modeling Study. SM Jenness, et al. Clinical Infectious Diseases, Volume 65, Issue 5, 1 September 2017, Pages 712–718.
AY Liu, et al. Sexual risk behavior among HIV-uninfected men who have sex with men participating in a tenofovir preexposure prophylaxis randomized trial in the United States. J Acquir Immune Defic Syndr. 2013 Sep 1;64(1):87-94.
Joseph Davey DL et al. Emerging evidence from a systematic review of safety of pre-exposure prophylaxis for pregnant and postpartum women: where are we now and where are we heading? Journal of the International AIDS Society, 23: e25426, 2020. https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.25426
There’s a lot of misinformation out there. We’re a fact and evidence-based zone.