Tristan Lai has been using an HIV-prevention drug known as PrEP since February 2017. But the daily pill came at a hefty price, sometimes costing upwards of $1,000 per month.
But Lai was lucky to have it covered through his private insurer, and thanks to grassroots efforts, PrEP, also known as pre-exposure prophylaxis treatment, has been made available free of charge to Albertans as of Oct. 1.
“People are finally given the choice,” Lai said, calling the provincial government’s decision to publicly fund the drug “a liberating move.”
But the work is far from over for community activists in Edmonton, who are now hoping to spread awareness about the drug with the long-term goal of lowering the overall rate of those who are HIV-positive in the province.
“A lot of what we’re doing right now has the potential to redefine the ways we think about sex (and) sexual health,” said Thomas Trombetta, a community educator with HIV Edmonton.
Trombetta has been hard at work the past few months hosting information sessions about PrEP, a prevention drug used by people who are at-risk of HIV infection. Previously, the cheapest version of the drug was available for a price tag of $250 per month, with a more expensive version available for upwards of $1,000 per month.
But as of last month, Alberta has made PrEP free of charge. It is the seventh province to do so in Canada, Trombetta said. Alberta’s Minister of Health Sarah Hoffman said in a statement that PrEP “is an important tool in the province’s work to address HIV rates.”
Trombetta said the shift to publicly fund the drug is essential for ensuring PrEP is available to at-risk groups that need it the most. “Now, it’s a choice for people,” he said.
According to the latest national data, from 2016, men who have sex with men continue to represent the largest proportion of HIV cases in adults at 44 per cent. But Trombetta said it’s important to recognize other groups are at-risk as well, including trans women, people who inject drugs, and Black and Indigenous populations, who each represent 20 per cent of all reported HIV cases in the country.
A survey done by the Edmonton Men’s Health Collective (EMHC) found that prior to the drug becoming publicly funded, 63 per cent of those who tried to obtain coverage or funding for the drug, through private insurance or other means, were unsuccessful. With the drug now publicly funded, Trombetta said he hopes those numbers will change.
“Now we have a lot of work to do to make sure that PrEP is accessible for those who benefit the most from it,” Trombetta said.Trombetta
Barriers remain for those looking to get a prescription for PrEP from their doctor. According to a list on PrEP Alberta’s website put together by the EMHC, less than 100 physicians in the province are eligible to prescribe it free-of-charge, and Trombetta said some of those doctors may not be accepting new patients. He said he hopes the list will expand in the coming months as awareness about the drug’s availability increases.
Lai said another way to increase access would be giving pharmacists the ability to prescribe PrEP as well. Currently, only physicians and nurse practitioners can do so.
“Getting an appointment with your family doctor is a lot harder than say walking to a pharmacy and talking to pharmacists,” Lai said.
While it is too early for specific numbers, Trombetta said that anecdotally, demand for PrEP has already gone up in Alberta since it became publicly funded on Oct. 1.
Along with advocating for ease of access, Trombetta is also hoping to educate the public about informed and responsible use of the drug. He said it’s important for people to remember that PrEP is only one tool for HIV prevention, and it does not protect against other sexually transmitted diseases.
But having access to PrEP remains an important piece for overall HIV prevention, said Brook Biggin, founder of the EMHC.
“I think it was a very smart move that’s based in science and not stigma,” Biggin said of Alberta’s decision to publicly fund the drug. “ … It demonstrates that the government takes the fight against HIV seriously, and is willing to invest in it.”