Canadian guidelines on HIV PrEP, testing, treatment and care

Prevention in Focus PiF 2026 Spring

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Guidelines use research evidence, the consensus of experts in the field, and practice-based evidence informed by experience to support the decision-making of frontline service providers. This article highlights HIV guidelines developed in Canada by a variety of sources including governments and expert groups. Some guidelines were developed for a national audience and are relevant across the country. Other guidelines were developed for a regional audience but may contain information that can be useful for service providers in other provinces and territories.

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Pre-exposure prophylaxis (PrEP)

Pre-exposure prophylaxis guidelines can include recommendations on screening people for PrEP use, prescribing PrEP, monitoring while on PrEP and stopping PrEP.

A group of clinicians, researchers and community members developed national guidelines for the prescribing of PrEP and post-exposure prophylaxis (PEP) in Canada. These guidelines include evidence-informed recommendations on how to assess patient eligibility for PrEP and how to correctly prescribe it. 

Guidelines have also been developed for PrEP delivery in specific provinces and territories:

Post-exposure prophylaxis (PEP)

Post-exposure prophylaxis guidelines cover the use of PEP after an occupational exposure, non-occupational exposure or both. They address infections, such as HIV, that may be transmitted by blood or other bodily fluids.

A group of clinicians, researchers and community members developed national guidelines for the prescribing of PEP and PrEP in Canada. These guidelines include evidence-informed recommendations on how to assess patient eligibility for PEP and how to correctly prescribe it.

Guidelines have also been developed by different provinces and territories to outline procedures following an exposure to blood and bodily fluids, including the use of PEP:

Testing

Testing guidelines address a range of factors that need to be considered when delivering HIV testing. Recommendations commonly cover screening people for HIV testing, testing in specific populations, testing frequency and test counselling. Some testing guidelines also address legal and ethical issues such as confidentiality and disclosure, and technical issues such as test types and technologies.

In Canada, the Public Health Agency of Canada has developed a guide with general recommendations for HIV testing that can be taken into consideration alongside any existing local or specialized practices. 

A number of provinces have developed testing guidelines that reflect approaches and procedures specific to the province:

For guidance on community-based HIV self-test kit distribution, a practice-based guidance document is also available:

Pregnancy and infant feeding

The Society of Obstetricians and Gynaecologists of Canada has developed several guidelines that address HIV-related considerations before, during and after pregnancy. They provide recommendations related to safer conception when one or both partners is living with HIV, HIV screening and testing during pregnancy, and the prevention of HIV transmission through pregnancy, childbirth and infant feeding:

For care providers wishing to learn more about the Canadian HIV pregnancy planning guidelines, an e-learning course is also available:

Recommendations related to infant feeding can also be found in this guideline:

Treatment and care guidelines

Treatment and care guidelines provide guidance for the care of people with HIV. They include treatment guidelines that provide direction on when to start drug therapy and which drug regimens to use. They also include healthcare management guidelines that provide recommendations on the delivery of routine healthcare for people with HIV by physicians and other healthcare and service providers.

The following Canadian HIV treatment and care guidelines are available:

For more Canadian and international guidelines, search the CATIE website.

About the author(s)

Erica Lee is CATIE’s manager of website content and evaluation. Since earning her master of information studies, Erica has worked in the health library field, supporting the information needs of frontline service providers and service users. Before joining CATIE, Erica worked as the Librarian at the AIDS Committee of Toronto (ACT).