Updated Canadian Guidelines Expand Access to HIV Prevention Tools

toronto, ON – December 1, 2025 – On World AIDS Day, updated Canadian guidelines for HIV prevention have been published in the Canadian Medical association journal (CMJ), offering 31 recommendations and 10 good practice statements to aid healthcare professionals in providing effective HIV prevention options to both teens and adults. The guidelines address both pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).

PrEP involves HIV-negative individuals taking antiretroviral medications before potential exposure to prevent infection, while PEP involves a 28-day course of antiretrovirals after a potential exposure.

“Canada is not at all on track to achieve its goal of eliminating HIV as a public health threat by 2030,” explains Dr. Darrell Tan, lead author and infectious disease physician at St. Michael’s Hospital. “Our aim with this guideline is to support front-line health care providers, policy-makers, community members, and others in expanding the use of these safe and effective tools for preventing HIV. A wide array of PrEP and PEP options now exists in Canada.We need to urgently expand their use until all people have equitable access to prevention strategies that they find suitable.”

Key Updates and Focus Areas:

This updated guidance, building on 2017 recommendations, highlights several crucial changes. Notably, the guidelines now explicitly recognize “self-identified need” as a valid reason to initiate PrEP.Furthermore,the range of PrEP options has expanded,including newer regimens administered as injections every two months.

The guidelines are designed to support clinical decision-making across a broad spectrum of healthcare disciplines – including primary care, infectious diseases, emergency medicine, sexual health, nursing, pharmacy, and community work. Easy-to-use reference tables detail medication regimens, indications, and monitoring protocols.

Addressing Disparities in Infection Rates:

The guidelines acknowledge that HIV infections in Canada are concentrated within specific populations. Current data shows:

* 38% of new infections occur in gay, bisexual, and other men who have sex with men (GBM).
* 25% occur in people who inject drugs (PWID).
* 4% occur in GBM-PWID.
* Over one-third of infections occur in females.
* Indigenous communities in Saskatchewan and Manitoba experience disproportionately higher rates of infection.

Call to Action:

The authors emphasize the need to address barriers to implementation, especially a lack of awareness regarding PrEP and PEP among both key populations and clinicians. They urge public health officials, professional societies, and community organizations to collaborate in promoting these strategies and tracking their uptake alongside existing HIV surveillance data.

This updated guidance represents a meaningful step towards achieving Canada’s goal of eliminating HIV as a public health threat by 2030,emphasizing the importance of accessible and equitable prevention strategies for all.

What factors contribute to the varying levels of public PrEP coverage across Canadian provinces?

New Canadian HIV Prevention Strategies Highlighted in Updated Guidelines

Understanding the Latest Recommendations for HIV Prevention in Canada

Canada’s approach to combating HIV is evolving, with updated guidelines reflecting the latest scientific advancements and a commitment to ending the HIV epidemic. These changes focus on expanding access to effective prevention tools and tailoring strategies to meet the diverse needs of communities across the country. This article details the key updates, focusing on PrEP, PEP, treatment as prevention, and harm reduction strategies. we’ll also explore how these guidelines align with Canada’s broader cultural preservation efforts, ensuring inclusivity in healthcare access.

Pre-Exposure Prophylaxis (PrEP): Expanding Access and Awareness

What is PrEP? PrEP involves taking a daily pill (or receiving an injection) to prevent HIV infection in people who are HIV-negative but at risk.

Key Updates:

* Increased Eligibility: Updated guidelines broaden eligibility criteria for PrEP, making it accessible to a wider range of individuals at risk, including those with inconsistent condom use, multiple sexual partners, or a history of sexually transmitted infections (stis).

* Injection Options: The introduction of long-acting injectable PrEP (cabotegravir) offers a convenient option to daily pills, possibly improving adherence and reducing the burden of medication.

* Provincial Coverage: While coverage varies by province, there’s a growing trend towards publicly funded PrEP programs, reducing financial barriers to access. Currently, Ontario, British Columbia, Alberta, Quebec, and Nova Scotia offer public coverage.

* Routine Screening: Healthcare providers are now encouraged to routinely screen individuals at risk for HIV and discuss PrEP as a prevention option.

Benefits of PrEP:

* Highly effective in preventing HIV infection when taken as prescribed (over 99% effective).

* Reduces anxiety and stress related to HIV risk.

* empowers individuals to take control of their sexual health.

Post-Exposure Prophylaxis (PEP): Timely Intervention is Crucial

What is PEP? PEP involves taking antiretroviral medications after a potential exposure to HIV to prevent infection. It must be started within 72 hours of exposure for maximum effectiveness.

Key Updates:

* Streamlined Access: Efforts are underway to streamline access to PEP, including expanding the number of healthcare providers authorized to prescribe it and reducing wait times for medication.

* Emergency Room Protocols: Enhanced protocols in emergency rooms ensure rapid assessment and initiation of PEP for individuals presenting after a potential exposure.

* Awareness Campaigns: Public health campaigns are raising awareness about PEP and the importance of seeking immediate medical attention after a potential exposure.

Crucial Considerations for PEP:

* PEP is not a substitute for ongoing prevention strategies like condom use.

* A full course of 28-day medication is essential for optimal effectiveness.

* PEP can have side effects,and individuals should discuss these with their healthcare provider.

Treatment as Prevention (TasP): Undetectable = Untransmittable (U=U)

The Power of U=U: A cornerstone of modern HIV prevention is the understanding that people living with HIV who achieve and maintain an undetectable viral load thru antiretroviral therapy (ART) cannot sexually transmit the virus to others. This is known as Undetectable = Untransmittable (U=U).

Key Updates:

* Promoting Viral Suppression: Increased efforts to support people living with HIV in achieving and maintaining viral suppression through consistent ART adherence and regular monitoring.

* Addressing Stigma: Combating stigma surrounding HIV and U=U to encourage testing, treatment, and open communication.

* Integrating U=U into Prevention Messaging: Public health messaging now prominently features U=U to dispel myths and promote confidence in HIV prevention.

Harm Reduction Strategies: Reaching vulnerable Populations

Addressing Social Determinants of Health: recognizing that HIV risk is ofen linked to social determinants of health, Canada’s guidelines emphasize harm reduction strategies tailored to the needs of vulnerable populations.

Key Strategies:

* Needle and Syringe Programs: Providing access to sterile needles and syringes to reduce the risk of HIV transmission among people who inject drugs.

* Opioid Agonist Therapy (OAT): Expanding access to OAT to reduce injection drug use and associated HIV risk.

* Supervised Consumption Sites (SCS): Offering safe and supervised environments for people to use drugs, reducing the risk of overdose and infectious disease transmission.

* Culturally Sensitive Outreach: developing culturally sensitive outreach programs to reach marginalized communities and provide HIV prevention services. this aligns with Canada’s commitment to preserving distinct cultural identities, as highlighted by institutions like the CBC and NFB [1].

HIV Testing: Know Your Status

Importance of Regular Testing: Regular HIV testing is crucial for early detection and treatment, which improves health outcomes and prevents further transmission.

Testing Options:

* blood Tests: Customary HIV testing method performed in a laboratory.

* Point-of-Care Tests: Rapid HIV tests that provide results within minutes.

* Self-Testing: Home-based HIV self-testing kits are becoming increasingly available, offering a convenient and discreet testing option.

Where to Get Tested:

* Public health clinics

* Community-based organizations

* Healthcare