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Updated: Jan 9, 2026
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Published on: March 30, 2014
Canadian guideline on HIV pre- and postexposure prophylaxis: 2025 update.
Darrell H S Tan1, Mark W Hull2, Stanley O Onyegbule2
1Division of Infectious Diseases (Tan, Onyegbule) and MAP Centre for Urban Health Solutions (Tan, Onyegbule, Ajiboye), St. Michael's Hospital, Toronto Ont.; Department of Medicine (Hull), University of British Columbia, Vancouver, BC; CATIE (Canadian AIDS Treatment Information Exchange) (Arkell), Toronto, Ont.; Clinique de médecine urbaine du Quartier latin and CHUM (Centre hospitalier de l'Université de Montréal) (Baril); Direction régionale de santé publique, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal (Cox, Lambert), Montréal, Que.; Department of Family Practice, Faculty of Medicine (Harris), University of British Columbia, Vancouver, BC; School of Pharmacy (Kelly), Memorial University of Newfoundland, St. John's, NL; Community-Based Research Centre (Kwag), Vancouver, BC; School of Nursing, University of Ottawa (O'Byrne), Ottawa, Ont.; Department of Emergency Medicine (O'Donnell), St. Paul's Hospital, Vancouver, BC; Cumming School of Medicine (Shukalek), University of Calgary, Calgary, Alta.; Division of Infectious Diseases, Department of Medicine (Singh), University of Alberta, Edmonton, Alta.; Department of Pediatrics, Division of Pediatric Infectious Disease, Division of Adolescent Health and Medicine (Sotindjo), University of British Columbia, Vancouver, BC Children's Hospital, Vancouver, BC; Leslie Dan Faculty of Pharmacy (Swidrovich), University of Toronto, Toronto, Ont.; Centre de recherche du Centre hospitalier de l'Université de Montréal ( Tremblay), Montréal, Que.; Department of Pharmacy (Yoong), St. Michael's Hospital, Toronto, Ont. darrell.tan@gmail.com.
Updated Canadian guidelines offer multiple safe and effective pre- and postexposure prophylaxis (PrEP and PEP) regimens to reduce new HIV infections. Clinicians should assess HIV risk and discuss suitable options with patients.
Area of Science:
- Public Health
- Infectious Disease Management
- Clinical Guidelines
Background:
- Annual new HIV infections in Canada necessitate updated guidance on pre- and postexposure prophylaxis (PrEP and PEP).
- The Canadian Institutes of Health Research (CIHR) Pan-Canadian Network for HIV/AIDS and STBBI Clinical Trials Research updated the 2017 guideline.
Purpose of the Study:
- To provide updated clinical indications and drug regimens for PrEP and PEP in Canada.
- To formulate evidence-based recommendations for HIV prevention strategies.
Main Methods:
- Expert panel convened, drawing on community consultations and systematic reviews (searches to June 2024).
- Used a formal evidence-to-decision-making framework and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system.
- Adhered to Guidelines International Network principles and Appraisal of Guidelines for Research and Evaluation II (AGREE II) reporting standards.
Main Results:
- 31 recommendations and 10 good practice statements were formulated.
- Clinicians encouraged to assess HIV risk and discuss various PrEP regimens (oral TDF/FTC, on-demand TDF/FTC, oral TAF/FTC, injectable cabotegravir).
- Preferred PEP regimens include dolutegravir + TDF/FTC or bictegravir/TAF/FTC, considering transmission likelihood and exposure type.
Conclusions:
- Multiple safe and effective PrEP and PEP options are available in Canada.
- Implementation of the guideline aims to increase access to biomedical HIV prevention.
- The guideline is expected to decrease the incidence of HIV in Canada.
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