Programming Connection

The PEP Program 

Clinique médicale l'Actuel
Montreal, Quebec
2010

Why Was the Program Developed?

In Canada, HIV continues to have a tremendous impact on gay men and other men who have sex with men. The Public Health Association of Canada estimated that 51% of all people living with HIV in 2008 were men who have sex with men, and 44% of all new infections in 2008 were attributed to sex between men. While certainly not all gay men and other MSM participate in risky sex, some men are at considerable risk of HIV and STIs through unprotected anal sex (including instances of condoms breaking) with partners of unknown or positive serostatus.   

L’Actuel has firsthand knowledge of the HIV and STI rates among gay men in Montreal. The medical clinic has been operating for more than 25 years in the gay village and serves a predominately GLBTQ population. 

Three key factors led to the clinic implementing a PEP service:

  1. Many of the gay men presenting at the clinic had recently been exposed to HIV. 
  2. The clinic was aware that PEP was widely accepted as a form of HIV prevention for exposures to HIV in occupational settings and in cases of sexual assault.
  3. The clinic came upon guidelines for the use of PEP for non-occupational exposure to HIV (e.g., exposure to HIV through consensual sex) developed in the United States.

Since Canada currently has no national guidelines for non-occupational exposure, the clinic used the U.S. guidelines and information from research and practice to inform the implementation of its PEP program.

See Other Useful Resources for more information.