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Continuing Truvada in Canada
Jul 17, 2006

Dear Dr. Conway,

I am currently in the US on Sustiva + Truvada. I have responded favorably to the regimen with almost no side effects and complete viral suppression. My CD4 count is slowly inching its way back up to 200 (from less than 100). Because of this, I would really prefer not to have to switch to another regiment unless it is absolutely necessary.

I am lucky enough to have both Canadian and British citizenships. I need to move to either Canada or the UK within the next month or so. After researching HIV care in both countries, it seems that Truvada is available in the UK but it has not yet passed Canada's CDR and is therefore not listed on formularies in any province, despite federal approval. What does this mean exactly? Will I be unable to continue treatment on Truvada if I do decide on Canada? If it is available, say through an expanded access program, will I have to jump through all sorts of hoops to get it?

One last question, I have empolyment prospects in British Columbia, Quebec and Ontario. Born to a Canadian parent abroad, I have never resided in Canada before and so have no provincial health plan/insurance. My coverage here in the US ends in July. Will I have to wait the required three months to establish residency in a province? Are there any exceptions made for someone who would be forced to discontinue treatment otherwise?

I am sorry if this is not quite the right forum for these two questions but you are the only fellow Canadian I found among the Forum Experts. I would prefer to move north rather than across the pond but these issues will drive my decision so any advice or information you could provide would be immensely appreciated.

Thank you for your time!

P.S. My sister just graduated from UBC, go Thunderbirds!

Response from Dr. Conway

Sorry for the delay in answering this question. Truvada is now fully approved in Canada and readily available in British Columbia. Its availability in Eastern Canada cannot be far away. In the Canadian health care system, if someone presents for care and needs life saving medications of any kind (including HIV medications), there is always a way to make it available immediately. You just need to be sure to consult with a physician who is experienced in the field of HIV, and things should be fine.

Should I now welcome you to Canada?

Am undetectable can kissing
buffalo hump

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