Some sexual health experts feel that unless the province publicly funds universal access to a prevention medication, the number of newly-infected cases could continue to increase.
“The recent announcement that Nova Scotia covers PrEP, didn’t finish the sentence. It covers PrEP under Pharmacare, but it still remains out of reach for most Nova Scotians,” Matt Numer said, an assistant professor at Dalhousie Universtiy and chair of the Nova Scotia PrEP Action Committee.
However, Numer says not all Nova Scotians qualify for the provincial Pharmacare program, and therefore those at high risk of HIV infection are still not adequately protected.
“It’s not going to actually increase PrEP for most people. Most people don’t qualify for the Pharmacare plan under which it’s currently funded,” he said.
PrEP is a medication that when used daily is up to 98 per cent effective at reducing the risk of transmitting HIV, according to the Canadian AIDS Treatment Information Exchange.
The cost of accessing PrEP on a monthly basis is around $460, according to Numer. He says by the provincial government adding the drug to its public health plan, the out-of-pocket expense of PrEP will decrease, but not by enough for everyone to be able to afford it.
“It did bring the out-of-pocket cost down, but for many Nova Scotians $260 a month on top of their regular expenses just isn’t a viable option,” he said.
According to Numer, other provinces in Canada, like British Columbia, provide PrEP at no cost to those who are clinically deemed at risk of HIV infection.
He wants the same for Nova Scotia.
“We need to get to a place that everybody in consultation with their physician who wants to be on PrEP, is able to get on PrEP, and have it fully funded,” he said.
Nova Scotia HIV frontlines
One of the panelists involved in the HIV discussion was Dr. Lisa Barrett, an infectious disease clinician who’s had a first-hand glimpse at the impact human immunodeficiency on a community.
“We had started to see that there was an increase it seemed, in the number of people who were turning up with new infections within Nova Scotia,” Dr. Barrett said.
Dr. Barrett says the infectious disease clinic she works in has concerns about populations at high risk of HIV infection, and that it’s important for the general public to be aware of their risk factors.
“A really important mechanism of transmission is sexually, and that can include all kinds of different sex, so we really need to think about safer sexual practices and sexual health,” she said. “However, HIV is also transmitted in other ways and that can be through injection drug use or drug use of other kinds where there’s snorting or sharing of paraphernalia.”
Dr. Barrett adds that people who use PrEP need more than just a pill to have the prevention method truly succeed.
“In every situation where we’ve tested PrEP, that means in a research setting or in communities where it’s been reported, it works when people take it and when they have a plan. So they take a pill, that’s part of it, but they also have a plan for repeat testing every three months to make sure they don’t have any other sexually-transmitted infections or HIV,” she said.
Dr. Barrett says that a lack of access to health care providers in the province increases the challenge of having a successful PrEP program.
“I think everybody in Nova Scotia within our government and Nova Scotia Health Authority wants to look after people well, but we have limited resources,” said Dr. Barrett. “That includes health-care providers and sexual health. We’ve been working towards building capacity, but if we’re going to do this well, we need to continue to add providers and resource and education into that community.”