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Advocates hope Manitoba will follow Ontario, cover costly HIV prevention drug

Manitoba advocates who work daily in the fight against HIV are hoping the province will follow the Ontario government's decision to cover the cost of a high-priced pill that prevents the virus.

The Ontario government added Pre-exposure prophylaxis, commonly known as PrEP, to its list of publicly covered drugs on Thursday. The drug is sold under the brand name Truvada and costs about $1,000 a month in Canada.

Studies show the daily pill can reduce the risk of HIV transmission 86 per cent or more.

PrEP has proven especially beneficial for those at high risk of acquiring the virus, including men who have sex with men, sex workers and those with an HIV-positive partner.

The decision to cover the cost of the drug has caught the attention of Mike Payne, the executive director of Nine Circles Community Health Centre in Winnipeg.

"Locally people [are] talking a lot about PrEP," said Payne, adding he knows of men in Winnipeg who've been buying the drug through unofficial means already outside of Manitoba — a risky way some have been forced to get it.

Nine Circles tests patients living with HIV and has been getting a lot of questions about PrEP recently.

"It's proven to be extremely effective," Payne said.

Before Thursday, Quebec was the only Canadian province to cover PrEP's cost; most insurance companies don't currently cover it.

In Manitoba, the government only covers the cost of emtricitabine/tenofovir (sold as Truvada) when it's used as treatment of HIV, not prevention.

The province told CBC that Manitoba Health's position hasn't changed on the matter and it is waiting for direction from the pan-Canadian Pharmaceutical Alliance, which is evaluating options on how to move forward with the drug that Health Canada approved last April.

'Could have used it 30 years ago'

Jim Kane, a Winnipeg man who's been living with HIV for over 30 years, he's waited years to see a drug like PrEP become available on the market and is happy to see science evolve — after losing friends and partners during the HIV crisis.

"We could have used it 30 years ago but better late than never," Kane said, adding he hopes the federal Liberals will throw some money into the health pot to help provinces cover the cost of PrEP.

​Public health officials in Toronto have expressed concern the drug could contribute to a rise in sexually transmitted infections as men on it may be less likely to use condoms.

Payne said a broader sex-positive conversation is needed to combat the stigma.

"It just comes from living in communities where we don't talk about sex and we don't talk about sexual health very often," Payne said.

Supporters of PrEP maintain it's more than just a pill. Patients need to be tested before going on it, are encouraged to have safe sex, and have to be in regular contact with their doctor about the drug.

For Ontario residents wanting PrEP, there will be an application process and a deductible that will range in cost depending on a person's income.

Payne hopes a generic cheaper form of PrEP will be accessible in Canada soon.