How to Get PrEP in Toronto Without a Family Doctor

What PrEP Is and How It Prevents HIV

PrEP stands for pre-exposure prophylaxis. It's a medication taken by people who don't have HIV to significantly reduce their risk of getting it. When taken consistently as prescribed, daily oral PrEP is up to 99% effective at preventing HIV through sexual contact. Among people who inject drugs, it reduces the risk by more than 74%. Those are some of the most compelling prevention numbers in modern medicine.

The medication works by maintaining a steady level of antiretroviral drug in your body. If you're exposed to HIV while taking PrEP, the drug prevents the virus from replicating and establishing a permanent infection. Think of it as a protective barrier at the cellular level. The virus can't gain a foothold, so it can't take hold in your body.

Two forms of oral PrEP are currently available in Canada. The most common is a daily pill taken at the same time each day. For certain individuals, an on-demand dosing schedule may also be appropriate. Your healthcare provider can walk you through which approach fits your situation and lifestyle. PrEP does not protect against other sexually transmitted infections, and it isn't a substitute for other safer sex practices like condoms. But as a specific tool for HIV prevention, it is remarkably effective.

Understanding what PrEP does leads naturally to the next question: is it right for you?

Who Should Consider Taking PrEP

PrEP is for anyone who may be at increased risk of acquiring HIV. This isn't limited to any particular identity, gender, or orientation. Risk is determined by behaviour and circumstances, not by who you are. There's no judgment involved, and there shouldn't be. Choosing to protect your health is always a reasonable decision, and nobody needs to justify why they're making it.

You might benefit from speaking with a healthcare provider about PrEP if any of the following apply:

• You have a sexual partner who is living with HIV, especially if their viral load isn't consistently suppressed
• You have multiple sexual partners
• You don't consistently use condoms
• You've been diagnosed with a sexually transmitted infection in the past six months
• You share needles or other injection equipment
• You have a partner whose HIV status you don't know, particularly when other risk factors are present

If one or more of these apply to you, that doesn't mean you've done something wrong. It means you're being proactive. PrEP is also approved for adolescents in Canada, though management for younger patients may involve additional considerations. If you have questions about preventive care for a teen or young family member, speak with a provider experienced in pediatric care.

Getting Started: From First Visit to Prescription

The Baseline Assessment

Before you can start PrEP, your provider needs to confirm a few things through baseline lab work. The most important test is for HIV itself. PrEP is only for people who are HIV-negative. Starting the medication while unknowingly HIV-positive could lead to drug resistance, which would seriously limit future treatment options. Your provider will also order blood work to assess kidney function, since PrEP can affect the kidneys in a small number of people. Screening for hepatitis B and other STIs rounds out the initial workup.

At Care&, this baseline lab work is done on-site at either the Yorkville or Lawrence Park location. You'll have your clinical assessment and blood draw in a single appointment, with no need for a separate trip to an external lab. Results typically take about a week to come back. Once those results confirm you're a good candidate, your Nurse Practitioner can write the prescription right away. No referral is needed, and there's no waiting for a specialist.

What to Expect at Your First Appointment

Your first visit will include a conversation about your sexual health and any relevant risk factors. You'll also discuss your goals for prevention and what you're hoping PrEP will do for you. These are personal topics, and they deserve real time and space. The NPs at Care& have clinical training and experience in LGBTQ+ health, and every conversation happens in a confidential, judgment-free setting. You can expect an unrushed appointment where your questions are answered thoroughly and your concerns are taken seriously.

Your provider will also explain how to take the medication, what side effects to watch for, and what the ongoing follow-up schedule looks like. By the time your lab results come back, you'll have a clear picture of your next steps. If everything looks good, you'll leave your follow-up visit with a prescription in hand.

With the clinical process clear, the next consideration for most people is cost.

PrEP Coverage and Costs in Ontario

Medication Costs

The cost of the PrEP medication itself is separate from the cost of your clinic visits. In Ontario, PrEP medication is covered by the Ontario Drug Benefit (ODB) for people who qualify, including those receiving Ontario Works or the Ontario Disability Support Program. Most private insurance plans through employers now cover PrEP as well. If you don't have private insurance and don't qualify for ODB, the Trillium Drug Program can help bridge the gap. Your provider or pharmacist can help you determine which coverage pathway applies to your situation.

Generic versions of PrEP medications are available in Canada, which has made the medication significantly more affordable than it was even a few years ago. If cost is a concern, don't let it stop you from asking about PrEP. There are options, and your provider can help you sort through them.

Clinic Visit Costs

Care& is not covered by OHIP. The clinic operates on a membership model designed to provide consistent, thorough care from the same provider at every visit. A Family Practice membership is $450 plus HST per year and includes unlimited in-person, phone, and video visits with your dedicated NP. If you'd rather not commit to a membership upfront, you can access PrEP services on a pay-per-visit basis at $100 per appointment.

For people who do have an OHIP-covered family doctor, PrEP visits at that office would typically be covered at no cost. But if you're one of the many Torontonians sitting on a waitlist, if your current doctor isn't comfortable prescribing PrEP, or if you simply can't get an appointment within a reasonable timeframe, there are alternatives available to you.

What Ongoing Monitoring Looks Like

PrEP isn't a one-time prescription. It requires regular follow-up to make sure the medication is safe and effective for you over time. The standard protocol calls for visits every three months. At each follow-up, your provider will repeat your HIV test, recheck kidney function, and screen for sexually transmitted infections. This monitoring catches any issues early and confirms that PrEP continues to be appropriate for you.

One of the biggest challenges for people on PrEP without a regular provider is maintaining that quarterly consistency. Every three months, you need someone who knows your health history and can track changes over time. When you see the same Nurse Practitioner at every visit, you're not re-explaining your situation from the beginning each quarter. Your NP already knows your baseline results and the concerns you've discussed at previous appointments. That kind of continuity matters for any ongoing medication, and it's the same principle that makes chronic disease management more effective when you have a dedicated provider.

Between visits, you can manage prescription refills and review your lab results through the Care& app, keeping your health information accessible from your phone. If anything comes up between scheduled follow-ups, you can reach your NP by phone or video without needing a separate appointment through your membership.

If you're pregnant, breastfeeding, or planning a pregnancy, discuss this with your provider before starting or continuing PrEP. The decision involves weighing the benefits of HIV prevention against other clinical considerations, and your provider can help you make an informed choice based on your individual circumstances.

When to Talk to Your Nurse Practitioner About PrEP

If you've been considering PrEP, the right time to bring it up is now. You don't need to wait for a specific event or reach a certain risk threshold to start the conversation. Prevention works best when it's proactive. Whether you're exploring PrEP for the first time, thinking about switching from another provider, or simply want to understand your options, your NP can help you assess whether PrEP is a good fit.

At Care& Family Health, PrEP is offered as part of a broader Family Practice model. You can learn more about how the process works, or visit the PrEP and HIV prevention page for details on getting started. Both the Yorkville and Lawrence Park locations serve patients across Toronto.

If you already have an OHIP-covered provider who can see you in a timely way and is comfortable prescribing PrEP, that's a perfectly good option for your care. Care& exists for people who can't get those timely appointments, who want longer and more thorough visits with a provider who knows their history, or who don't currently have a family doctor and need a reliable alternative.

Frequently Asked Questions