HIV Prevention

HIV prevention has the power to eliminate HIV. In order for prevention to work, strategies must take into account women's life circumstances.

Prevention

Currently, the main methods of protection against HIV transmission are:

Condoms and other physical barriers when engaging in sexual activity
Harm Reduction and Safer Drug Practices
HIV treatment to reduce the viral load of people living with HIV
Pre-Exposure Prophylaxis (PrEP)
Post-Exposure Prophylaxis (PEP)

Power imbalances in women’s lives impact their capacity to prevent HIV transmission. Women need accessible and affordable self-controlled methods of prevention that do not require the knowledge or consent of their sexual and/or injection partners. As research advances and new prevention technologies are made more accessible, prevention for women is improving.

Condoms and Other Physical Barriers

How they work and different options

Condoms are physical barriers that can reduce the risk of a sexual exposure to HIV and sexually transmitted infections (STIs). They are made of materials that do not allow HIV or STIs to pass through them. Condoms are highly effective against HIV and STI transmission when used consistently and correctly.

What are the options?

External Condoms

External Condoms (sometimes referred to as a "male condom"). External condoms are typically made of latex but polyurethane options are also available. These are to be worn on the penis* during sex.

*Trans, 2-Spirited and Non-Binary people may refer to their genitals using different language. For more information about language and safer sex with Trans women, see Brazen: Trans Women’s Safer Sex Guide.opens in a new window

Internal Condoms

Dental Dams

Flavoured or Non-Lubricated Condoms

Find more information on preventing HIV and STI transmission through condom use.opens in a new window

HARM REDUCTION & SAFER DRUG USE PRACTICES

SAFER DRUG USE PRACTICES HAVE PROVEN TO REDUCE HIV TRANSMISSION

How does harm reduction impact HIV transmission?

"Distributing harm reduction equipment for safer injecting, smoking and snorting has been proven to be an effective way to prevent or reduce many potential harms, including the risk of HIV and hepatitis C transmission. Programs that distribute harm reduction equipment can often be an important point of contact with the healthcare system for people who use drugs, and they can help people to access other community supports services. Combining harm reduction equipment distribution with other programs can increase their effectiveness." Reducing harms for people who use drugs: Emerging approaches and time-honoured programs

More information about harm reduction practices and program locations across Ontario.

Want to read more about WHAI & Harm Reduction?

HIV Treatment and Viral Load Suppression including Undetectable = Untransmittable

Undetectable = Untransmittable*

Research has shown that the consistent and correct use of HIV medications by people living with HIV can lower a person’s viral load to undetectable levels. When a person living with HIV maintains an undetectable viral load for at least 6 months, they cannot transmit the virus sexually to other people. In 2015, approximately 80% of people living with diagnosed HIV in Ontario were virally suppressed.

Undetectable = Untransmittable is changing the lives of many people living with HIV; however, there are important considerations that are relevant for women.

Learn more about U=U and Womenopens in a new window.

Viral load testing is part of routine checkups for people living with HIV who are engaged in care and on treatment. Accessing and staying engaged in care has shown improved health outcomes for people living with HIV, and is a very effective prevention tool.

Learn more about suppressing viral load as a prevention methodopens in a new window.

Pre-Exposure Prophylaxis (PrEP)

What is PrEP?

Pre-Exposure Prophylaxis (PrEP) is a prescription medication for HIV-negative people to reduce their risk of contracting HIV. PrEP is a combination of two drugs that fight against HIV known as “antiretrovirals” and is typically taken daily. PrEP is safe and has been approved by Health Canada. To learn more about PrEP, check out the following links:

Ontario PrEPopens in a new window

Virtual PrEP Action Toolkitopens in a new window

PrEP & Women: What You Need to Knowopens in a new window

5 ways that PrEP highlights gender inequities in HIVopens in a new window

Women + PrEP: 5 Important Factsopens in a new window

Does it work?

Trans Women

People Who Use Drugs and Sometimes Share Equipment

Pregnancy, Breast & Chest Feeding

Why is PrEP important for women?

There are numerous potential advantages of PrEP. For example, PrEP may provide another method of protection for people who:

Have an HIV+ partner
Do not always use condoms
Have multiple sex partners
Do not know the HIV status of all sex partners
Use drugs and sometimes share equipment*
Are trying to get pregnant with an HIV+ partner

* Note: Research has shown PrEP to be slightly less effective when used to prevent transmission related to sharing injection equipment. Talk to a health care professional for more information about your options.

Is PrEP accessible?

The Ontario Drug Benefit (ODB) program provides coverage for PrEP. This means that if you are collecting ODSP, OW, are enrolled in the Trillium Drug Program, or are over 65 years old, PrEP is now covered. ODB will also cover drug costs for those under the age of 24 who do not have private insurance as part of the OHIP+ program. PrEP is covered for First Nations and recognized Inuit people (with status) through the Federal Non-Insured Health Benefits Program. Some private insurance plans (i.e. coverage through a workplace or that you purchase on your own) may cover some or all of the cost of PrEP.

PrEPStart and PrEPSaver provide financial advice and support to help getting started on PrEP and find access to coverage.

If you do not have coverage through any of these means, PrEP is very expensive. It can cost between $250 - $1000 per month. Community groups continue to advocate for accessible PrEP. If you have questions, or face barriers accessing PrEP, contact your local health care provider or AIDS service organization

Learn more about PrEP, including information about microbicides and other new forms of PrEP in developmentopens in a new window

Download WHAI's 'PrEP & Women: What You Need to Know' pamphletopens in a new window

Post-Exposure Prophylaxis (PEP)

What is PEP?

PEP refers to a prescribed medication that prevents HIV acquisition for anyone who may have recently been exposed to HIV infection. As PEP is not 100% effective, starting earlier can increase its effectiveness. It can be prescribed up to 72 hours after exposure and the sooner it is accessed the more effective it can be.

How can you get PEP?

PEP can be accessed through emergency rooms and the cost will be covered by OHIP if you are accessing PEP after experiencing sexual assault, accessing after occupational exposure (such as a needle-stick injury), or if you are under the age of 25 and are not covered by a private insurance.

For other high-risk exposures, the cost of PEP can be expensive. If you don’t have private drug insurance and are over the age of 25, a month’s supply of PEP can cost around $1,000. If you are unable to afford PEP, you can work with emergency room staff and ask if they can help you find a way to access PEP at lower or no cost. It is important to note that across Ontario, access to PEP in emergency rooms can be inconsistent. PEP may not be readily available and the decision to prescribe PEP will be left to the discretion of the healthcare provider.

When might women want to get PEP?

Tips for Accessing PEP

Not every emergency room has the same access to and experience prescribing PEP. Be prepared as you can to advocate for yourself!
If you need support, bring someone you trust such as a friend or service provider with you.
Be prepared to discuss the details of your exposure. This can be very difficult to do but the more honest and detailed you can be, the more the intake healthcare provider can understand what happened and get you the care you need.
It’s recommended that you get tested for HIV as soon as possible after a potential exposure (this is a baseline test to assess if there was HIV present before the potential exposure), at 3 weeks after the exposure, and at 6 weeks after the exposure. Ask your doctor about how to plan for follow up steps. Ontario Guidelines for Providers offering HIV Testing (2023)opens in a new window
As PEP’s effectiveness is time sensitive, ask where you can get the medications immediately after leaving. If it is outside of pharmacy hours, you can ask if they provide a starter kit for taking the medications prior to picking up PEP from a pharmacy.

Download WHAI's 'PEP & Women: What You Need to Know' pamphletopens in a new window

CENTRING WOMEN'S EXPERIENCES

"We must avoid creating two classes of people with HIV; those who have an undetectable viral load and those who do not."

— Ontario AIDS Networkopens in a new window

RESOURCES

Report

WHAT CAN WE HELP YOU FIND?

HIV Prevention

HIV prevention has the power to eliminate HIV. In order for prevention to work, strategies must take into account women's life circumstances.

Prevention

Condoms and Other Physical Barriers

How they work and different options

What are the options?

HARM REDUCTION & SAFER DRUG USE PRACTICES

SAFER DRUG USE PRACTICES HAVE PROVEN TO REDUCE HIV TRANSMISSION

HIV Treatment and Viral Load Suppression including Undetectable = Untransmittable

Undetectable = Untransmittable*

Pre-Exposure Prophylaxis (PrEP)

What is PrEP?

Post-Exposure Prophylaxis (PEP)

What is PEP?

CENTRING WOMEN'S EXPERIENCES

RESOURCES

Ontario Guidelines for Providers Offering HIV Testing

PEP & Women

PrEP & Women

Women and Harm Reduction in Ontario: A Capacity Building Toolkit

Living in the Asterisk(*)

Brazen

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