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5d ago

Canada Updates HIV Prevention Guidance, Endorses PrEP on Request

Authors frame the CMAJ update as a tool to expand equitable access after recent increases in HIV diagnoses.

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New data released by the Public Health Agency of Canada says there was a small decline in new HIV diagnoses in 2024, though the numbers in Manitoba and Saskatchewan are still three or four times the national rate.
Dr. Darrell Tan, an infectious diseases specialist at St. Michael's Hospital in Toronto, is the lead author of the Canadian Medical Association Journal's new clinical guidelines for HIV prevention medications.
New data released by the Public Health Agency of Canada says there was a small decline in new HIV diagnoses in 2024, though the numbers in Manitoba and Saskatchewan are still three or four times the national rate.

Overview

  • The CMAJ guideline released Dec. 1 sets out 31 recommendations and 10 good-practice statements for PrEP and PEP use across clinical settings.
  • Prescribers are urged to offer PrEP to anyone who asks without requiring disclosure of risk factors, explicitly discouraging gatekeeping.
  • The update incorporates daily and on-demand pills plus a long-acting injectable given every two months that Health Canada approved in 2024.
  • PHAC reports rising diagnoses from 2021 to 2023 with a 35% jump to 2,434 cases in 2023, while new 2024 data show 1,826 diagnoses excluding Quebec, which doctors say is not a meaningful decline.
  • The guidance calls for public-health leadership, stigma‑reducing messaging, uptake tracking, and focused outreach to disproportionately affected groups, with advocates noting gaps for some Indigenous communities in the Prairies.