People who use drugs & those without stable housing
People who use drugs, especially those who lack stable housing, can face a number of challenges which make accessing PrEP, taking PrEP as prescribed, and completing necessary follow-up requirements challenging.
Those supporting people in these situations may need to provide more support at different points throughout the process to help them overcome the barriers they might face. Examples include:
Challenges accessing a PrEP prescription: Some healthcare providers may assume that people who use drugs or those without stable housing will be unable to adhere to PrEP or complete the necessary follow-up requirements. Clients may require someone to help them advocate on their behalf to help overcome this barrier.
Challenges adhering to PrEP: Some people who use drugs can face challenge taking PrEP as prescribed. Tips to increase adherence include::
Taking medication at the same time every day (perhaps after main meals or together with other medications)
Downloading an app or setting a reminder on your phone (i.e. medisafe app, thesexyouwant.ca/reminder)
Storing the medication somewhere visible
If someone is using recreational drugs, making a plan as to when and how they will take their medication
In addition to general adherence challenges, those without stable housing may face challenges finding a safe place to store their medication so that it is not lost or stolen. They may need the support of a community-based organization or their pharmacy to find a medication storage that works for them.
Challenges completing follow-up requirements: PrEP requires regular follow-up appointments to ensure someone remains HIV negative, to check for other STIs, and to monitor possible side effects. Making these appointments can be more challenging for some people who use drugs or lack stable housing. In these circumstances, clients would likely benefit from coordination between healthcare and service providers so that these follow-up requirements (like bloodwork) could be completed when clients access other services.