Grant: Catalyst Grant: HIV/AIDS CBR Program - General Stream

Pre-exposure prophylaxis (or PrEP) is a way for people who are at high risk of acquiring HIV to prevent infection by taking two HIV medications on a regular basis. However, access to PrEP might differ considerably depending on where people live, their access to specialists who are comfortable prescribing the drug and in some cases, their income. Access to PrEP is especially important for youth and young adults, considering the life-long potential for HIV-related stigma and discrimination and that, in Ontario, nearly one-quarter of new HIV diagnoses occur among individuals less than 30 years of age. Research at the population-level is therefore needed to understand who is prescribed PrEP and how PrEP is being delivered. In Ontario, researchers now have access to the information needed to do such studies. That is, because the province of Ontario now pays for all medications for people aged 24 and under, we can use Ontario's health care databases to answer questions about PrEP use in youth and young adults. Working with community partners, we will use these databases to answer these specific questions: 1) What are the characteristics of young adults prescribed PrEP and how do these differ from those of young people being diagnosed with HIV; 2) Who is prescribing PrEP and how does access vary by doctor's specialty and where people live in Ontario; 3) Are young adults prescribed PrEP receiving guideline recommended monitoring, such as tests for side effects involving the kidneys and 4) Do youth and young adults prescribed PrEP persist with treatment? For each question, we will also study whether differences exist between young women and men, between immigrants from countries with a high prevalence of HIV and non-immigrants and, by where people live in Ontario (e.g. large versus small cities). We will establish a research collaborative to help define our questions and ensure that results are available in formats that are meaningful and useable to community partners.