COVID-19 Update

If following physical distancing for you means not having sex with with other people, you may want to consider stopping PrEP.

You can stop taking PrEP until you’re having sex with people again, and it won’t affect PrEP’s effectiveness. If you want to stop taking PrEP, here are some important things to keep in mind:

• Ask yourself if this is the right step for you: are you confident that you are not going to be having the kind of sex that you would want to be taking PrEP for? Maybe it’s worth it to continue taking PrEP to help with your general anxiety around HIV? Is it going to be hard for you to go back to a routine of taking PrEP once you want to restart? 
• If you decide to stop taking daily PrEP, try to consult with your physician or nurse practitioner who prescribes you PrEP. This will help make sure you’re doing what works for you, and keep your prescriber up-to-date with your medication regimens.

How to stop safely: 

• If you’re taking PrEP daily and want to stop, you need to take it a couple of more times after the last time you had sex to make sure you’re covered:
  • Continue taking PrEP for two days after the last time you had anal sex before stopping.
  • Continue taking PrEP for seven days after the last time you had front-hole (vaginal) sex and bottomed.

If you decide to have anal sex after stopping PrEP daily, remember that taking PrEP On Demand is a good way of preventing HIV.  PrEP on demand is not currently recommended for those of us with a front hole.

If you’re horny and still having sex in-person during the COVID-19 pandemic, PrEP continues to be an effective way of preventing HIV.

Here are some things to know about continuing to take PrEP during COVID-19.

• While we’re all adjusting our routines to the new reality, it’s important that we remember that for PrEP to work, you have to take it regularly, and follow your doctor’s instructions. That can mean either taking it daily, or on-demand. 
• The Outpatient Pharmacy at St. Paul’s Hospital is refilling PrEP prescriptions even without current bloodwork. However, your physician or nurse practitioner may determine that it’s necessary in your case and may require you to get bloodwork before submitting a refill. 
• Communicate with your physician or nurse practitioner and listen to their instructions on how you should take PrEP so that it’s effective for you.

PrEP at a HIM Health Centre.

• HIM on DAVIE and HIM on the Drive: if you need bloodwork done for an upcoming PREP appointment please take your lab requisition to the closet Lifelab location. 
• HIM in Surrey, New West, and Abbotsford: Health centres in the Fraser Health Region are closed until further notice. If you are currently on PrEP and work with a healthcare provider in the Fraser region, you should have no delays or interruptions. Please ensure that you are giving enough time for appointments, and refills. Do not leave this to the last minute. 

St Paul’s hospital Lab has reopened but appointments are strongly recommended. Appointments can be booked at: https://www.providencelaboratory.com/for_patients.php

If you have questions about your PrEP medication and you live in the Fraser Region, please call: 604-476-7087.

The process of picking up PrEP continues as usual. When picking up your medication, remember that pharmacies and hospitals are places where people are more exposed to viruses and illnesses. The Outpatient Pharmacy at St. Paul’s Hospital is near the gift shop, and away from the emergency department, and other areas of the hospital where people might be very sick. But health care workers are doing their work in the hospital, so please take physical distancing very seriously when you are in the hospital. Please review the recommended COVID-19 safety tips before visiting the pharmacy:

• Wash your hands before and after leaving home for at least 20 seconds and avoid touching your face.
• Sanitize your hands before and after entering the pharmacy/hospital.
• Minimize touching door handles, buttons with your hands to open doors when possible.
• Avoid touching any surfaces, including counters, and any other shelved items.
• Cover your mouth and nose with disposable tissue or the crease of your elbow when you sneeze or cough.
• Maintain physical distancing of 2 metres (over 6 feet) with the people around you.

The Outpatient Pharmacy at St. Paul’s Hospital asks that you provide adequate time for them to prepare your medication. This means specifying your pick-up date and giving 3-7 days of advance notice whenever possible. You have 30 days to pick up your medication after the Outpatient Pharmacy at St. Paul’s Hospital receives your prescription and confirmation from you that you want it filled. As conditions evolve everyday, you are asked to pick up your prescription as soon as possible to avoid any delays and disruptions.

If you have any symptoms such as fever, cough, or difficulty breathing, or if you have travelled outside of Canada in the past 14 days please stay at home and don’t go to the pharmacy. Seek the guidance of your healthcare provider or call 8-1-1  HealthLink BC line, and consider an alternative option for picking up your PrEP:

• Consider having a friend or family member pick up your PrEP on your behalf. It’s best to call the pharmacy and/or leave a voicemail, and tell the pharmacy the name of the person who will be picking it up and an identifier about you such as your date of birth.
• If you cannot arrange for a friend or family member to pick up your medication, you can arrange for an alternative method of obtaining your medicine with St. Paul’s Hospital Pharmacy (at 604-806-8081) by leave a voicemail and asking that they phone you back, or with your designated pharmacy.

PEP is a series of medications that an HIV-negative person takes after an event where there is serious exposure to HIV. Such events include penetrative sex without PrEP or condoms. In these cases, PEP helps prevent us from picking up HIV.

Don’t confuse PEP with PrEP. Unlike PrEP, PEP is taken AFTER a serious exposure to prevent HIV transmission.

You can learn more about PEP here.

PEP is for emergency situations where you think you may have been seriously exposed to and may pick up HIV. This includes penetrative sex without PrEP or condoms. While you may want to think carefully before having this type of sex during COVID-19, we recognize that we may find ourselves in situations where we may be exposed to HIV.

In these cases, here are some things to know about taking PEP during COVID-19:

• PEP continues to be available at all of the sites that have been offering it: emergency departments throughout the province and HIM’s Health Centre on Davie.
• If going to an emergency department for PEP, remember that these are spaces where people are more exposed to viruses, including COVID-19. Take precautions to minimize your and others’ exposure to COVID-19. (See “Picking Up Your PrEP Prescription” for safety tips)
• Remember that PEP has to be started within 72 hours of your potential exposure to HIV, and the sooner the better. That’s because after 72 hours HIV has had enough time to establish itself in our body. That means that you cannot put off going on PEP until the COVID-19 pandemic passes.