Ask Your Pharmacist

December 17, 2020
Q:

I saw recently that it was World AIDS Day. I’ve never been tested for HIV or sexually transmitted infections (STI) but I think I should be. How can I get that done in New Brunswick?

A:

Good for you for making the decision to get testedWorld AIDS Day occurs during the month of December (December 1, 2020). It’s a good reminder to get tested for HIV and other STIs. If you are sexually active, testing is nerve-racking but ignoring your status does not make it go away. Fourteen per cent of Canadians do not know they are HIV positive.

For the majority of 2020, our attention has been understandably consumed by the COVID-19 pandemic. Beginning with the first cases of GRID (i.e. Gay Related Immunodeficiency Disorder) in San Francisco, the Human Immunodeficiency Virus (HIV) has been another devastating pandemic during the century. HIV wiped out a generation of men who have sex with men, as well as other vulnerable among us. In 2002, HIV was the leading cause of death worldwide in people ages 15 to 59 years of age. No cure has been found for HIV, but activism, advocacy, and research has resulted in treatment and preventative medication therapy that will make it possible for us to end the HIV pandemic during our lifetimes.

Treatment with Highly Active Anti Retro Viral Therapy (HAART or ART) has extended the lifetime of a young Canadian living with HIV to his/her early 70’s. Medication therapy, in some cases regimens as simple as one pill taken once daily, makes it possible to suppress the HIV viral load in a person with HIV in the blood to a level that is undetectable. This makes it very difficult to transmit HIV to an uninfected partner.

For those who are sexually active and at risk of HIV, they can prevent themselves from becoming infected with the virus by taking a once daily medication known as Pre-Exposure Prophylaxis (PrEP). I personally take once daily PrEP known as Truvada (emtrictabine/tenofovir disoproxil fumarate 200 mg / 300 mg). When taken every day correctly, PrEP is 99 per cent effective at protecting me from new HIV infection. PrEP is not a license for unprotected sex with multiple sexual partners. It is a tool to be used along with good decision-making and proper monitoring in partnership with your physician or nurse practitioner. PrEP does not protect against other sexually transmitted infections.

PrEP is covered by many private insurance companies as well as by the New Brunswick Prescription Drug Program. For those who do not have private insurance, a generic is available that costs about $266 monthly. For me, taking the pill is part of my morning routine while waiting in the line-up of the drive-thru at Tim’s. When I reach for my change, I take my pill. I also get blood work done every three months to make sure that my body is tolerating the medication well, to screen for HIV and to screen for other sexually transmitted infections that PrEP does not protect against.

If you are having sex with more than one sexual partner, if you are having unprotected sex in a non-monogamous situation, or if you are an IV drug user, or if you are at risk of HIV infection, talk to your pharmacist, doctor or nurse practitioner about the benefits/risks of PrEP for you. 

If you are not comfortable asking your health care provider about HIV testing, you can access testing (as well as a prescription for PrEP if appropriate) from one of New Brunswick’s Sexual Health Clinics (https://www2.gnb.ca/content/gnb/en/departments/ocmoh/cdc/content/sexual_health_clinics.html).

In 2020, Health Canada approved the first home testing kit for HIV, INSTI HIV. It is a one-minute finger prick test, and it is intended to reduce the barriers of getting tested for HIV. The kit can be ordered online for approximately $36 at https://www.insti.com/hiv-self-test/ .

Together we can extinguish HIV during our lifetime.

Dr. Kevin Duplisea (PharmD BSc. Pharm, BSc. ACPR) is a pharmacist at Sharp’s Corner Drugstore in Sussex, New Brunswick. His opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.