Some provinces offer free preventive HIV drug coverage. Quebec should join, say advocates - Action News
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Montreal

Some provinces offer free preventive HIV drug coverage. Quebec should join, say advocates

The PreEP pill is a medication taken by those who are HIV-negative but at risk of exposure to HIV. As diagnosis rates climb across the country, some experts say it's time for Quebec to expand its coverage of the drug.

Barriers include cost, ignorance among family doctors, says HIV expert

A man in green cotton sweater standing outside in front of a shipping container that's been converted
Alexandre Dumont Blais, executive director of RZO, says its Zone Rose testing facility inside a converted shipping container has been very popular this season. (Chloe Ranaldi/CBC)

The shipping container turned STI and HIV testing clinic, known at the Zone Rose, has reopened for its second season in the heart of Montreal's Gay Village.

But although the site's popularity is growing, the executive director of the organization behind it, RZO,says something is still missing: free access to HIV preventive medication pre-exposure prophylaxis, or PrEP.

Alexandre Dumont Blais says he wants to seeMontreal join other jurisdictionsin offering the medication for free, especially as the rate of HIV diagnosis is on the rise across the country.In 2022, HIV cases in Montreal jumped 120 per cent, according to the city's public health agency.

The pill is a medication taken by those who are HIV-negative but at risk of exposure to HIV.

"In a housing crisis, in an inflation situation, sometimespeople who are at risk do not take PrEP because of a budget question,"said Dumont Blais.

"The new statistics remind the importance of checking what strategies we have on the table and where we can put more energy to increasethese strategies."

People covered under Quebec's public health insurance plan,RAMQ,or by a private insurer can pay between $70 and $100 per month if they take the medication every day. However, uninsured individuals can see that amount climb to $250, said Dumont Blais.

Lack of awareness among doctors an issue

HIV specialist and physician Dr. Rjean Thomas adds that access to private coverage doesn't always mean someone is going to feel comfortable enough to resort to the family plan and submit a claim for PrEP.

Aside from the price tag, Thomas,who is alsothe president and co-founder of the medical clinic l'Actuel, says there are other barriers to access that have driven people from as far asChicoutimi, Que., to the Montreal clinic to obtain the pill.

Of the"thousands" of patients registered with the clinic who are on PrEP, 50 per cent have a family doctor that has refused to prescribe the medicationsimply out of ignorance, if not discomfort, said Thomas.

"It's not very well known in the medical community. It's not very well known among pharmacists or just generally outside the gay community," he said.

"The issue of talking sex with [a] family doctor is a real issue.It's still a subject that's difficult in 2024."

A man's tattooed arm is extended in front of green grass. Blue pills rest on the hand.
PrEP is prescribed as a pill in Canada. Though some people take it daily, Dr. Rjean Thomas says the medication rate depends on the person's sexual lifestyle and that in any case it's not taken for life. (Vanessa Blanch/CBC)

For Dumont Blais, the solution lies in the creation of a provincewide program offering the pill for free, at least to vulnerable members of the population such as those who are newly arrived to the country.

Provinces such as Alberta, British Columbia and Saskatchewan offer the medication for free under their provincial health insurance for at-risk individuals. Further to the east, Ontario offers it to people 24 and under who aren't already covered by a private insurance plan, a move replicated by Manitoba just recently.

Thomas says it's a matter of priorities; someone who contracts HIV can undergo treatment for decades which ultimately comes at a greater cost to society than a co-ordinated provincial preventioncampaign.

"It's always better to prevent than to cure you cannot cure AIDS," said Thomas.

In a statement to CBC News, a spokesperson for the Quebec Health Ministryemphasized that Quebec was the first province to authorize PrEP and that the drug's been covered under RAMQ since the beginning. Plus, Quebec pharmacists can prescribe the pill, widening its accessibility.

"There are no plans to reimburse 100 per cent of the costs for medication against HIV," wrote ministry communications director Francis Martel.

He addedthere are generic versions of the drug that are also available at a lower cost.

With files from Chlo Ranaldi