Rejean Thomas’s 400 words

Réjean Thomas, MD

PrEP clinics receive people who want to take PrEP (sexual pre-exposure prophylaxis) or who have questions about it.

An appointment at a PrEP clinic allows you to meet a doctor and a nurse who take the time necessary to:
•Assess the person’s level of risk;
•Evaluate the person’s possibility of taking PrEP;
•Explain PrEP and its use (continuous or intermittent);
•Answer all questions. It is important to carefully assess, on a case-by-case basis, whether PrEP is indicated.

•Men and women having sex with other people of the same sex;
•People whose partner is infected with HIV and not yet treated;
•Injecting drug users who do not consistently use sterilized needles and syringes.
HIV infection remains a major concern in the gay community in Quebec. The number of new diagnoses increased by 17% between 2009 and 2013. Among men, three-quarters (76.4%) of new diagnoses are men who have sex with men (MSM). Additionally, the trend of new diagnoses shows an increase among young MSM under the age of 35.

PrEP is for HIV-negative people who are at high risk of contracting HIV and want to reduce that risk. Before starting PrEP, you should:
•Take an HIV screening test to know the serological status;
•Carry out a blood test to check, in particular, that there are no medical contraindications;
• Screen for other sexually transmitted infections (STIs).

The treatments used for PrEP are Truvada and Descovy, tablets that are taken once a day by mouth. These drugs contain 2 antiretrovirals that block the HIV replication cycle and prevent it from multiplying in the blood and contaminating the body. These treatments may cause mild side effects, such as nausea or headaches, especially at the start of treatment. Most side effects are short-lived. It is important to discuss this with the doctor.

Although rare, other more serious side effects can occur with PrEP; hence the need to perform a blood test before and after.
People on PrEP should be followed every 3 months. The most recent studies have shown that PrEP reduces the risk of HIV infection by 92%, if the treatment is strictly followed. PrEP is not 100% effective, does not protect against other STIs, and does not replace condoms.

Editor’s note: The Clinique l’Actuel in Montreal hosts a PrEP clinic, you can find out more at 514-524-1001 or at