Responding to critiques of the Canadian PrEP guidelines: Increasing equitable access through a nurse-led active-offer PrEP service (PrEP-RN)

HIV pre-exposure prophylaxis (PrEP) is the use of HIV medications by HIV-negative persons to prevent HIV acquisition from future potential or known exposures to this virus. Multiple studies have demonstrated its efficacy in this regard. In 2017, to help increase the use of PrEP in Canada, clinical practice guidelines were published. These summarized the available literature and made recommendations for men who have sex with men (MSM), persons who engage in injection drugs use (IDU), and heterosexual persons. Recently, arguments were made to suggest that these guidelines are not inclusive of other minority populations in Canada, including persons of African, Caribbean, and Black (ACB) descent and Indigenous persons. In this article, we review these critiques, and overview our approach to risk assessments for PrEP. Specifically, we detail the clinical procedures of our nurse-led PrEP clinic in Ottawa (entitled PrEP-RN). Lastly, we present preliminary uptake data for PrEP-RN, and discuss their meaning.