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On July 1, 2024, pharmacists in Nova Scotia became among the first in Canada with the power to prescribe Pre-exposure Prophylaxis (PrEP), a preventative daily medication that makes people who take it correctly nearly impervious to HIV. 

The Nova Scotia College of Pharmacists, which regulates the practice of pharmacy in Nova Scotia, has enabled pharmacists to prescribe for PrEP. This change was made following the results of a pilot study conducted by Dalhousie health researcher Dr. Kyle Wilby, director of Dalhousie’s College of Pharmacy.

Now that pharmacists have prescribing authority, planning is taking place to fully implement this scope into practice, beginning at select pharmacies. The expectation is that the first prescriptions will be written in early fall.  

“We’re extremely pleased by the reception we’ve gotten from pharmacists in the province who are curious about this expansion of their scope of practice and interested in implementing it. But given that it requires new actions and workflows, such as requesting and analyzing blood work, it will take a bit of time for the service to become widespread,” says Dr. Wilby who has been conducting training sessions on the new requirements with pharmacists in the province. 

Dr. Wilby’s six-month study, supported by Shoppers Drug Mart, allowed him and his research team to follow 50 patients at 10 pharmacies, tracking the experience from both sides of the counter. The results were positive, with pharmacists keen to provide the service and patients eager to pursue it in the future. 

Enabling pharmacists to prescribe PrEP allows patients to more easily access this drug, while helping to decrease the burden on primary care physicians, nurse practitioners and Sexual Health Nova Scotia. An increased use of PrEP is also expected to decrease rates of HIV in the province, as well as other STIs detected in regular blood testing required to maintain an ongoing prescription.

The most recent data from Statistics Canada notes 1,833 new diagnoses of HIV in 2022, a 25 per cent increase over 2021. The virus leads to a greater risk of infections, cancers, and cardiovascular and liver disease. The emotional burden of managing and disclosing HIV can seriously impact mental health. And Canadians continue to die of the virus – 133 in 2021.

Bev Zwicker, CEO and registrar of the Nova Scotia College of Pharmacists, says the research completed by Dr. Wilby provided the insight to land on the decision.

"This is about determining when somebody would benefit from a medication for prevention,” says Zwicker. “So, when Dr. Wilby came to us, it was clear that this would be a role that pharmacists could play in protecting people from HIV. Then it was just a matter of developing the necessary safeguards to ensure that it happens safely.”

PrEP works by using antiretroviral medications to prevent HIV infection. When taken daily, these drugs maintain a consistent level in the bloodstream and tissues. If exposed to HIV, the medication inhibits the virus's ability to replicate and establish an infection by blocking key enzymes needed for viral replication.

Dr. Wilby’s research team included representation from Nova Scotia Health, Nova Scotia College of Pharmacists, Pharmacy Association of Nova Scotia, School of Pharmacy at Memorial University, Community Based Research Centre, and Halifax Sexual Health Centre.

Learn more via Dal News: https://www.dal.ca/news/2024/07/26/dalhousie-study-hiv-drug-nova-scotia.html

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Media contact:

Andrew Riley
Senior manager, research and innovation communications
Dalhousie University
902-456-7904 
andrew.riley@dal.ca