An assessment of HIV pre-exposure prophylaxis access in Nova Scotia

Background: The HIV pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy, but access in Nova Scotia has not been well characterized.This study evaluated PrEP access in Nova Scotia by examining prescribing and dispensing practices, uptake, and the demographics of individuals using PrEP.Methods: A descriptive analysis was conducted to track persons who used PrEP from 2019 to 2023.The numbers and geographic locations of prescribers and dispensing pharmacies were determined using their respective licence numbers.The linear distance between patients and providers was calculated to determine the distance travelled to access PrEP services.Results: The rate of persons who were dispensed PrEP in Nova Scotia doubled from 2019 to 2023, and the male-to-female ratio increased from 7:1 in 2019 to 15:1 in 2023.Most dispensations occurred to those aged 30-34 and to those located in the Central Zone.The number of prescriptions increased by 139.9%.The number of PrEP prescribers increased by 116%.In 2023, 38.5% of clinicians prescribed PrEP only once.The number of pharmacies that dispensed PrEP between 2019 and 2023 was 236.Most users travelled a distance less than 20 kilometres to access the service.Conclusion: These findings will inform targeted actions to increase PrEP access in Nova Scotia.More work is needed to address the lack of increased uptake by females and to expand PrEP access outside of the Halifax Regional Municipality.Ensuring that more individuals at high risk have access to this effective prevention method can help curb the spread of HIV in the province.