OHESI would like to share a newly released report by The Ontario HIV Treatment Network (OHTN) titled “HIV pre-exposure prophylaxis in Ontario”.
HIV pre-exposure prophylaxis (PrEP) is the use of daily antiretroviral medications by HIV-negative individuals to reduce their risk of HIV infection. PrEP is a highly effective HIV-risk reduction strategy and a critical part of a comprehensive approach to HIV prevention. It is important to monitor PrEP uptake to provide information to improve access and identify implementation gaps. However, Ontario does not currently have a provincial-level monitoring system for PrEP. To fill this gap, the OHTN is using pharmacy data on PrEP prescriptions to summarize PrEP uptake in Ontario between 2015 to 2018.
This report contains projected provincial-level estimates based on PrEP medication dispensation data from more than 2,000 pharmacies across Ontario. The estimated number, percent or rate of PrEP users is described overall, by sex, age, prescriber specialty, payment type and by region between July 2015 to June 2018. The estimated number of physicians prescribing PrEP by prescriber’s region between March 2018 to February 2019 is also described.
Key findings of the report include:
- By mid-2018, approximately 3,000 people were on PrEP in Ontario: an 8-fold increase from mid-2015 (estimated 374 PrEP users).
- Between mid-2015 and mid-2018, the vast majority (97%) of PrEP users were male.
- While males in the 30-39 age category consistently made up the greatest proportion of PrEP users, the greatest relative increase in male PrEP users between 2015 to 2018 was in the 19-29 age category.
- In the middle of 2018, the majority of estimated PrEP users were prescribed PrEP by family and general practitioners (68%), followed by infectious disease (14%), and internal medicine (5%) physicians.
- While approximately 77% of PrEP users used private insurance to cover the cost of the medications in mid-2018, the proportion of PrEP users using public coverage increased between 2015 and 2018as more public coverage became available.
- By mid-2018, almost 60% of the estimated PrEP users were dispensed PrEP from a pharmacy in the Toronto core region but between 2015 to 2018 the relative increases were greatest in regions outside Toronto core.
- Over 700 physicians prescribed PrEP at least once between March 2018 and February 2019, over 40% of whom were located in the Toronto core region.