The legal framework
Treatment and PrEP are covered through provincial drug plans, but the terms differ substantially: some provinces provide treatment at no cost to the patient, others apply deductibles and co-payments. The distinctive Canadian issue is legal: the Supreme Court has held that failing to disclose HIV status before sex can amount to aggravated sexual assault, subject to a threshold defined by viral load and condom use.
Key points
| Coverage | Provincial drug plans; terms differ significantly between provinces |
|---|---|
| British Columbia | Treatment and PrEP provided at no cost through a centralised programme |
| Testing | Free through public health; self-tests approved and sold in Canada |
| PEP | Available in emergency departments; coverage varies by province |
| Criminal law | Non-disclosure can constitute aggravated sexual assault |
| Threshold | The Supreme Court set out when disclosure is not required, based on viral load and condom use |
| Indigenous health | Non-Insured Health Benefits cover eligible First Nations and Inuit clients |
In practice
- Check your province's drug plan terms before assuming treatment is free.
- Take advice from a legal organisation specialising in HIV before making disclosure decisions.
- Self-tests are available and can be used privately before engaging with services.
- For PEP, attend an emergency department immediately.
Cost and coverage
Costs depend on the province and on private insurance; several provinces provide treatment at no charge.
Where to go
- Provincial HIV programmes and sexual health clinics.
- CATIE, the national knowledge exchange service.
- HIV legal networks for advice on disclosure.
Worth knowing
The criminal law on non-disclosure is complex and has been applied unevenly. Prosecution guidance has narrowed in several provinces, but the underlying law has not changed: specialist legal advice is essential.
Official sources and links
- Public Health Agency of Canada — STI guidance and surveillance
- CATIE — national HIV and hepatitis C knowledge exchange
- Canada.ca — official government portal
- Justice Laws Website — federal statutes and regulations