PrEP

Stay Safe!!! PrEP Now is free in Manitoba!

What is PrEP

  • PrEP stands for Pre-Exposure Prophylaxis to help keep HIV-negative people from catching HIV.

  • PrEP is a medication that, if taken properly, can reduce the risk to catch HIV through sex by over 99%.

  • PrEP also can reduce the risk to catch HIV through shared paraphernalia used to inject drugs.

  • Manitoba Health now pays the costs for PrEP, so it is free.

Who is eligible for free PrEP

The Manitoba PrEP criteria are different for specific groups of people.


To see if you qualify, click on the group that best describes you:

    1. Somebody who has had anal sex without a condom in the last six months, and any of:

      • Infectious syphilis, gonorrhea, or chlamydia in the past 12 months

      • Needed post-exposure HIV medication more than once

      • Have an ongoing sexual relationship with HIV-positive partner(s) with a high viral load, or whose HIV status is unknown but from a higher-risk population like Men who have Sex with Men, or people who inject drugs.

      • Have a high HIV risk score based on sexual practices (HIRI-MSM risk score ≥ 11)
Get your score here: HIRI Score

    2. Gender-diverse people are included in the eligibility criteria as incorrect assumptions can be made about the sexual practices of individuals.

    3. PrEP is not indicated for people in a monogamous relationship with a single partner, or if a partner has an undetectable HIV viral load, or if their HIV status is unknown but whose risk is similar to the general population.

    1. Recommended for the HIV-negative person with ongoing exposure to HIV-positive partner(s) involving condomless vaginal or anal sex, where the HIV-positive partner(s) has a substantial risk to transmit HIV (not on, or taking treatment as prescribed)

    2. Consider PrEP for the HIV-negative person in similar situations where the HIV-positive partner(s) has a lower, but non-zero risk to transmit HIV:

      • viral load detectable or

      • viral load usually undetectable but also had an STI present at time of exposure

      • HIV status unknown, but from a high-prevalence population – Men Who Have Sex with Men, injected drug use, or coming from a country with high rates of HIV.

    3. PrEP is not indicated for people in a monogamous relationship with a single partner, or if a partner has an undetectable HIV viral load, or if their HIV status is unknown but whose risk is similar to the general population

  • PrEP may be considered when there is ongoing or anticipation of ongoing sharing of injection drug use paraphernalia with somebody who might have untreated HIV:

    • Detectable viral load or

    • HIV status unknown but from a high-prevalence population – Men Who Have Sex with Men, injected drug use, or coming from a country with high rates of HIV.

Medication used for PrEP

  • The most commonly used pill for PrEP is Emtricitabine/Tenofovir (E/T), Truvada®
or a generic equivalent.

  • Other formulations of the E/T are available, but not covered by Manitoba Health.

  • E/T can be taken either once a day, or for a short course before and after sex. 
Manitoba Health covers only daily use.

  • A long-acting injected form of PrEP is not yet licensed for use in Canada.

  • For anal sex, E/T must be taken for a week before it can be fully effective.

  • For vaginal/front hole sex, E/T must be taken for a month before being considered fully effective.

  • The use of E/T does not replace the use of condoms since the drug does not protect against syphilis, chlamydia, gonorrhea, hepatitis, herpes, or warts.

Side-effects of Emtricitabine/Tenofovir

  • Taking E/T before bed might lessen the experience of side-effects.

  • When on E/T, kidney, blood, and in some cases, bone health must be monitored.

  • Resistance to E/T, and similar drugs, can happen if the medication is taken by somebody with HIV, so ongoing HIV testing is necessary.

Getting PrEP at OOHC

  • Make an appointment in our Sexual Health Clinic. Make the appointment online, or call 204-691-1600.

  • Read about PrEP here before your appointment.

  • You will need to be seen again after one month on PrEP, and then every 3 months after.

  • Your appointments will involve a physical examination. We also will test for HIV and other STIs with urine, and throat and rectal swabs (depending on your sexual activities). You also will need to get blood work to test for HIV, syphilis, hepatitis, kidney function, blood cells, and pregnancy (if indicated). All bloodwork will need to be done at a lab facility, such as Dynacare.

  • If your blood results show that it is safe to start PrEP, your doctor will issue a prescription for the medication.

  • Prescription refills for E/T will be made only if you come to the OOHC Sexual Health Clinic every 3 months.

  • Please get an appointment in the Sexual Health Clinic before your prescription runs out.