HIV, PrEP and Sexual Health in Quebec in 2026: Prevention, Testing and Resources

The State of the HIV Epidemic in Quebec in 2026

The HIV Infection Surveillance Program of the Institut national de santé publique du Québec (INSPQ) recorded 1,110 cases in 2023 and 1,122 cases in 2024, with 41% being first diagnoses and 59% previous diagnoses, meaning individuals already known to services elsewhere. These levels are the highest observed in Quebec since the early 2000s. The rate of first diagnoses stabilized in 2024 at 5.1 per 100,000 people, still 45% higher than in 2019.

The picture reveals two opposing trends. On one hand, newly arrived individuals in Canada, born outside the country and settled for less than six years, accounted for 62% of first diagnoses recorded in 2023-2024: the epidemic's increase is concentrated in this group. On the other hand, the number of first diagnoses decreased by 32% between 2015 and 2024 among those born in Canada or established longer, a decline notably attributable to prevention, including PrEP.

Of the 462 first diagnoses in 2024, the majority still affects the Montreal region, but the share observed outside the metropolis rose from 31% in 2023 to 42% in 2024. The Health and Welfare Commissioner estimated in 2025 that about 19,101 people were living with HIV in Quebec in 2022, with nearly 11% unaware of their status. These figures justify regular testing, without waiting for symptoms.

To place these data in a comprehensive health approach, the site also offers a complete guide to LGBTQ+ health and wellness resources in Quebec, listing clinics, helplines, and services by region.

PrEP in Quebec: Covered by the RAMQ, Now Also Injectable

Pre-exposure prophylaxis (PrEP) involves taking antiretroviral treatment before being exposed to HIV to prevent infection. In Quebec, oral PrEP has been covered by the public drug insurance plan of the RAMQ since 2017: an eligible person under the public plan does not have to bear the full cost of the tablets, subject to the applicable contribution of their drug insurance plan.

Usage followed coverage. The Public Health Agency of Canada (PHAC) reports 37 PrEP users per 100,000 people in Quebec in 2018, 61 in 2021, and 75 in 2022, across all genders. A study published in the Canada Communicable Disease Report (CCDR) in January 2025 estimated 23,644 people on PrEP in Quebec in 2021. These data, available with a few years' delay, describe the period preceding the latest wave of diagnostic increases.

A notable option was added to the landscape in March 2025: Quebec became the first province to list APRETUDE, the long-acting injectable treatment (cabotegravir), on the list of reimbursed medications. Administered by quarterly injection in a clinical setting, this formulation suits individuals for whom daily intake is challenging, with an efficacy of around 99% according to the Quebec fact sheet distributed by organizations.

PrEP is not suitable for everyone and requires a medical evaluation: prior HIV testing, kidney function monitoring, and regular testing for other sexually transmitted and blood-borne infections (STBBIs). It is precisely this comprehensive follow-up that makes it a complete sexual health tool, not just a medication. To prepare for these appointments and engage with healthcare professionals, consult the guide on LGBTQ+ cultural competence in healthcare settings.

After a Risk Exposure: Post-Exposure Prophylaxis (PEP)

Post-exposure prophylaxis (PEP) is the second safety net. It is a 28-day antiretroviral treatment, started as soon as possible after potential HIV exposure — unprotected sexual intercourse, condom accident, assault — and no later than 72 hours. Every hour counts: the sooner the treatment starts, the higher the probability of preventing infection.

In Quebec, PEP is accessible in hospital emergency services. No need to wait for a clinic appointment: go to the emergency room explaining the exposure, with exposure source information if possible. The emergency room assesses the risk, prescribes the treatment, and organizes follow-up, including initial testing and subsequent blood tests.

Two useful clarifications. First, PEP is an emergency treatment, not a regular prevention method: for repeated exposures, PrEP should be discussed with a healthcare professional. Second, PEP does not protect against other STBBIs: a complete screening (HIV, syphilis, gonorrhea, chlamydia, hepatitis) is still recommended a few weeks after exposure, and follow-up recommendations should be confirmed by the receiving service.

Getting Tested: Rapid Test, Self-Test, and Clinics

HIV testing in Quebec is done by blood draw in a clinic, by rapid test (blood taken from a fingertip, result in about twenty minutes), or by self-test. Community organizations distribute self-tests and offer free or low-cost testing in non-judgmental settings — a real advantage for those who fear medical environments.

In Montreal, the organization RÉZO, which works with gay, bisexual, and other men who have sex with men, offers a clinic called the Zone Rose, where free access to HIV and other STBBI testing, information, and prevention materials is available. The Clinique l'Actuel, a Montreal medical clinic specializing in STBBIs, is another well-known entry point. In other regions, the Portail VIH/Sida du Québec lists local organizations offering testing and support.

The calendar also counts: every November, the International Testing Week, coordinated in Quebec by COCQ-SIDA, multiplies walk-in testing activities and the distribution of self-tests in several cities across the province. It's the ideal opportunity to take a first test or retake one.

How often should you get tested? The answer depends on your life: the recommended frequency varies according to the number of partners, PrEP use, or the occurrence of an STBBI. The simplest reflex is to talk frankly with a healthcare professional or community worker, who will help set an appropriate pace. Young people will find suitable listening resources in the guide to resources and helplines for LGBTQ+ youth.

Modern Treatment: Living with HIV and U=U

An HIV diagnosis is no longer what it used to be: current antiretroviral treatments, often reduced to a daily intake, allow for an almost normal life expectancy and quality of life. They also protect others: a person whose viral load has been undetectable for at least six months and who follows their treatment does not transmit HIV sexually. This scientific consensus, known as U=U (undetectable equals untransmittable), has been affirmed since 2018 by the international scientific community, notably by the International AIDS Society.

However, Quebec remains below the international UNAIDS targets (95-95-95), according to the Health and Welfare Commissioner (November 2025): 89% of people living with HIV know their status, 82% of them receive treatment, and 96% of treated individuals have an undetectable viral load. The weak link is therefore between testing and treatment initiation — exactly where community organizations and frontline services can make a difference.

Rapid treatment initiation after diagnosis improves both individual health and prevention. In Quebec, antiretrovirals are covered by the RAMQ, and organizations like ACCM (AIDS Community Care Montreal) support newly diagnosed individuals, offering support, listening, and assistance in the process.

Community Organizations: A Pillar of the System

The Commissioner for Health and Well-being highlights in his 2025 portrait: community organizations play an essential role on the ground in the fight against HIV, despite precarious funding. They are the ones offering local testing, distribution of self-tests, prevention, guidance towards care, and services to populations that the system struggles to reach.

These organizations complement the public network: they do not replace a doctor or an emergency room, but they lower the barriers — financial, cultural, psychological — that delay testing and care. For a first contact without an appointment or judgment, they are often the best entry point.

Stigma, Rights, and Late Diagnoses

Nearly half of new HIV diagnoses in Quebec (49% in 2022) were late, meaning they were made at a stage where the immune system was already affected. The Commissioner for Health and Well-being attributes this delay to a range of factors: stigma, which persists both in the population and in healthcare settings, financial, administrative, and cultural barriers, and the documented fear of criminalization for non-disclosure of serostatus, which sometimes discourages testing itself.

On the rights side, resources exist. The COCQ-SIDA's VIH info droits service offers legal information by a lawyer on legal issues related to HIV, and community organizations also support individuals facing discrimination cases. On a daily basis, the psychosocial aspect is as important as the medical aspect: the mental health of LGBTQ+ individuals is a known determinant of access to care, and the stress related to minoritization weighs on the pursuit of testing and treatment. The site dedicates a comprehensive dossier on LGBTQ+ mental health and minority stress, with its support resources.

Finally, the public consultation launched by the Commissioner for Health and Well-being in the fall of 2025, whose participation period ended in March 2026, aims precisely to build a more coherent response to these issues. The assessments cited here will outline the directions.

Taking Action: Where to Start

Whether you are looking to prevent, get tested, or support a loved one, the following steps cover the most common situations. Adapt them to your reality, and do not hesitate to contact a community organization for guidance.

1. I want to prevent: discuss PrEP with a healthcare professional; check your eligibility for RAMQ coverage and, if daily doses concern you, inquire about the injectable option APRETUDE.
2. I have just had a risky exposure: head immediately to the nearest emergency room to evaluate post-exposure prophylaxis — the maximum delay is 72 hours, and every hour counts.
3. I want to get tested: choose the option that makes you most comfortable: blood test in a clinic, rapid test, or self-test distributed by a community organization; consult the Portail VIH/Sida du Québec to find a service point near you.
4. I have just learned that I am living with HIV: an effective treatment covered by RAMQ exists; organizations like ACCM support new diagnoses, and U=U ensures that an undetectable viral load does not transmit the virus.
5. I am experiencing stigma or have legal questions: the COCQ-SIDA's VIH info droits service offers legal information, and community organizations can refer you to help.

HIV prevention works when tools are known and accessible: PrEP and PEP to prevent, regular testing to know your status, early treatment to protect your health and that of others. It is a collective effort, and Quebec's community organizations have been the driving force for forty years.