Vancouver

Canada / Vancouver

OVERVIEW

In Vancouver, you will find a wide range of health care options. Contraceptive methods, including condoms, pills, patches, shots, etc, are widely available. While contraceptives are not subsidized by the Canadian health care system for all people, you can find lower-cost pills and IUDs (including insertion) at public sexual health clinics. You can purchase emergency contraception ("the morning after pill") at pharmacies or obtain it at sexual health clinics. There are no formal age restrictions but pharmacists can refuse to dispense EC to people who do not seem "mature." There are many public sexual health clinics that offer STI tests. While some only cover HIV, other clinics can test for a range of STIs, especially if you make an appointment rather than dropping in. There is an HPV vaccination program in place. You can access Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP). Regarding abortions, they are legal and there are no formal restrictions. If you're not a Canadian citizen or permanent resident, you can expect to pay $300-$900 for the procedure, but there are some financial assistance resources available.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Canada, you can find condoms sold in many stores. For other birth control options, like the pill, IUD, shot or implant, you will need a prescription from a physician or nurse.

Generally, Canada has a high rate of contraceptive use. It's estimated that over 70% of Canadian women (of reproductive age) use modern contraceptive methods, and about 22% of Canadian men have underwent male sterilization. Yet some women still face difficulty when trying to access birth control. The Society of Society of Obstetricians and Gynaecologists of Canada found that Canadian women have less birth-control options than women in other developed countries. Furthermore, the Canadian Contraception Consensus report found that 15% of sexually-active Canadian women aren't using any form of birth control, and 20% are using birth control inconsistently. The largest barrier is probably cost. Contraceptives aren't free under Canada's universal health care plan, and affordable birth control options are typically found through the public sexual health clinics (which can have limited drug choices, limited opening hours and long wait times). It should be stressed, however, that these clinics do provide affordable options and are an invaluable resource in Canada.

What to Get & Where to Get It

• Generally speaking, you can find contraceptives (birth control) services at a variety of clinics in the Vancouver area. Some clinics you may want to check out are Vancouver General Hospital: Women's Clinic, Everywoman's Health Centre, Willow Women's Clinic, and The Elizabeth Bagshaw Women’s Clinic. Some clinics require an appointment, and some take clients on a walk-in basis. You should contact them in advance or visit their website to find appointment details.
• You can find condoms sold in a variety of locations and venues, such as pharmacies, clinics, government programs, and online stores. No prescription is required. For online options, you can check out Top Condoms Canada, IdealCondoms.ca and Undercover Condoms.
• If you want oral contraceptives (birth control pills), you will need a prescription. You can obtain a prescription for a licensed health care provider, which can be found at a clinic or health facility. Once you have a prescription, you can obtain birth control pills from a variety of pharmacies or clinics. It's important to note that Canadian health insurance does not always cover birth control pills (see "Costs" section below for details).
• If you want the contraceptive ring (Nuvaring), you will need a prescription. You can obtain a prescription for a licensed health care provider, which can be found at a clinic or health facility. Once you have a prescription, you can obtain the contraceptive ring from a variety of pharmacies or clinics.
• If you want the contraceptive patch (Evra), you will need a prescription. You can obtain a prescription for a licensed health care provider, which can be found at a clinic or health facility. Once you have a prescription, you can obtain the contraceptive patch from a variety of pharmacies or clinics.
• If you want the contraceptive injectable (Depo-Provera), you will need a prescription. You can obtain a prescription for a licensed health care provider, which can be found at a clinic or health facility. Once you have a prescription, you can obtain the contraceptive injectable from a variety of pharmacies or clinics.
• If you want an intrauterine device (IUD), you can find hormonal (such as Mirena, Kyleena, and Jaydess) and copper IUDs available. However, you will need to obtain a prescription, and you will need to schedule an insertion procedure. You should contact a licensed health care provider or clinic for details.
• The contraceptive implant (Implanon, Nexplanon) is not yet available in Canada, as of 2018. However, you can find clinics that provide implant removal procedures.

Costs

• While Canada has a universal health care system, it does not offer free contraceptives to everyone. However, you can get lower-cost birth control at the public sexual health clinics, and some health plans do cover free birth control (such as the Safe Methods Program).
• You can expect to pay between $0.50 to $2.00 per condom, as of 2018.
• You can expect to pay between $15.00 to $30.00 for a one-month supply of birth control pills, as of 2018.
• You can expect to pay between $15.00 to $30.00 for a one-month supply of Nuvaring (the contraceptive ring), as of 2018.
• You can expect to pay between $15.00 to $30.00 for Evra, the contraceptive patch (which lasts for 7 days), as of 2018.
• You can expect to pay between $40.00 to $50.00 for one shot of Depo-Provera (which lasts 3 months), as of 2018.
• You can expect to pay between $7500 to $90.00 for the copper IUD (which lasts 5 to 10 years), as of 2018.
• You can expect to pay between $300.00 to $400.00 for the hormonal IUD (which lasts 3 to 5 years), as of 2018.

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex in order to prevent pregnancy. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC.

Tip: WhatsNextForMe.ca is a Canadian website developed by a group of physicians and researchers based at Women’s College Hospital in Toronto. It provides information about what emergency contraception options are available in Canada, how they work and how to get them. General information on emergency contraceptives can also be found here and here.

Laws & Social Stigmas

In Canada, the emergency contraceptive pill (the morning after pill) is available at a variety of places, including women's clinics, sexual health centres, hospitals, and pharmacies. However, the laws around its availability vary by province. In British Columbia and most provinces, emergency contraceptive pills are available over-the-counter, except for Ulipristal-based pills, such as ellaOne, which requires a prescription. In Quebec, emergency contraceptive requires a prescription, and in in Saskatchewan, it is available behind the counter at pharmacies.

Generally speaking, age restrictions on emergency contraception vary by province. In British Columbia and many other provinces, there are no age restrictions, so young people and teenagers are legally allowed to purchased emergency contraceptive pills without a prescription or parental consent. However, there may be some age restrictions when purchasing EC. As reported by the International Consortium for Emergency Contraception, "In May 2008, the National Association of Pharmacy Regulatory Authorities (NAPRA) recommended full OTC access for the LNG regimen with no age restriction. This recommendation is being applied Under Common Law; however, pharmacists have the discretion to restrict sale of EC if a woman does not appear mature. All provinces follow Common Law with the exception of Quebec, which follows Civil Code, and Saskatchewan."

What to Get & Where to Get It

Note: The longest-lasting EC is currently ellaOne. It lasts up to 5 days (120 hours) after unprotected sex. It seems like ellaOne is available in Canada. However, a prescription may be require to purchase it. Check with your pharmacist or local sexual health clinic for details.

• You can obtain most emergency contraceptive pills (morning after pills) without a prescription from a pharmacy, doctor, women's clinic, sexual assault centres, sexual health clinics, or hospital emergency rooms.
• In Canada, if you want dedicated progestin only EC, you can take NorLevo 0.75 mg (available over the counter) or Plan B (available over the counter). You should take 150mgs available in some places as 2 pills, or sometimes just 1 pill, within 120 hours after unprotected sex. If you can't access dedicated EC, you can use some oral contraceptives as replacement EC -- but, remember: in 28-day packs, only the first 21 pills can be used. Some of the contraceptives you can use are Ovral (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later), Minovral (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later) and Alesse (take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later).

Costs

Prices vary, depending on where you bought the emergency contraception. If you go to a pharmacy, you can expect to pay around $23-$30 (as of 2013). If you go to a community health clinic, you can expect to pay around $13-$20 (as of 2013).

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

In Canada, there are no travel restrictions attached to STI or HIV status. However, if you wish to stay in Canada for over 6 months, you'll need to get an HIV test. If you test positive, you probably won't be granted a residency permit. You will still be issued a residence permit if you fall into one of the following categories: you're an HIV-positive refugee, you're an HIV-positive sponsored spouse or common law partner of a Canadian citizen or permanent resident, or if you're an HIV-positive sponsored and dependent child of a Canadian citizen or permanent resident.

As reported by HIVTravel, "Accessing health care in Canada is expensive for non-Canadian residents or visitors and the cost varies from one province to another. Canada is a federation of provinces and territories and health care is the responsibility of each province or territory. Access to services can vary a bit from one province to another. In general, visitors to Canada need private health insurance from their home countries to pay for major medical costs here." For more details on HIV treatment for foreigners in Canada, click here.

Testing Facilities

• Tip: You can use the Smart Sex Resource to find testing clinics in your area.
• Tip: There are three main types of clinics for STI tests in British Columbia. The first is STD/STI clinics, which provide free, confidential testing and diagnosis for STIs. At these clinics, HIV tests are non-nominal which means that the tests can be relatively anonymous, since you don't need to present a care card and your full name is not reported to public health officials (just your first name, initials, and birth date). The second is family doctors/general practitioners, where you can get free tests. However, the tests are confidential -- not anonymous -- meaning that the client’s full name is used and is therefore connected to the results. The third is opt clinics, where you can get free tests. However, the tests are confidential -- not anonymous -- meaning that the client’s full name is used and is therefore connected to the results.
• British Columbia STD Control - BCCDC Clinic: Free and confidential, No MSP required, STI counselling, testing and treatment, HIV counselling and testing, and Hepatitis B vaccine. Address: BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC V5Z 4R4. Phone: 604-707-5600
• British Columbia STD Control - Outreach clinic: Testing for sexually transmitted infections (STIs) and HIV for gay, lesbian, queer, transgendered and bisexual people. Free, no ID needed. Address:Bute Street Clinic (upstairs in Qmunity), 1170 Bute Street, Vancouver, BC, V6E 1Z6.
• Options for Sexual Health: "Options for Sexual Health is the largest non-profit sexual health organization in Canada, and has 60 clinics all around B.C. Opt's clinics along with the affiliated organizations and individuals listed below are part of a network of sexual health service providers who you can access when you need to talk about sexuality or sexual health. We are committed to providing you with confidential, nonjudgmental, youth-friendly, pro-choice, and sex-positive services. For updates and details on Opt clinic closures please visit our Clinic Closures page ."
• Willow Women's Clinic: They provide free STI tests if you have a valid BC Care Card. Phone: +1 604-709-5611.

Support

• HIV Helpline: They have an online helpline, "..where anyone can ask a question anonymously and have it answered by our knowledgeable volunteers."
• AIDS Vancouver: This organization was established in 1983 as the first HIV/AIDS organization in Canada. They now provide a variety of services, including managing the HIV Helpline (see above), community case management, a grocery program, support programs, a financial assistance fund, and a health promotion program. They also have educational resources and policy positions on their website. Address: 1101 Seymour Street, Suite 235, 2nd Floor, Vancouver, BC V6B 0R1, Canada. Main Telephone: 604-893-2201. Email: contact@aidsvancouver.org
• British Columbia Centre for Excellence in HIV/AIDS: "The B.C. Centre for Excellence in HIV/AIDS is dedicated to improving the health of British Columbians with HIV through the development, ongoing monitoring and dissemination of comprehensive research and treatment programs for HIV and related diseases." Address: 608 – 1081 Burrard Street, Vancouver, B.C., Canada V6Z 1Y6, General telephone: 604-806-8477. Fax: 604-806-9044. Email: info@cfenet.ubc.ca
• Canadian Aboriginal AIDS Network: "CAAN provides a National forum for Aboriginal Peoples to wholistically address HIV and AIDS, HCV, STBBIs, TB, Mental Health, aging and related co-morbidity issues; promotes a Social Determinants of Health Framework through advocacy; and provides accurate and up to date resources on these issues in a culturally relevant manner for Aboriginal Peoples wherever they reside."
• Pacific AIDS Network: "The Pacific AIDS Network (PAN) works collaboratively with almost 50 member organizations and people affected by HIV and hepatitis C to build capacity and skills for stronger communities in British Columbia." Phone: 604.569.1998. Email: info@pacificaidsnetwork.org
• Canadian Liver Foundation: Helps people with Hep B and Hep C. "The Canadian Liver Foundation is a national non-profit organization committed to promoting liver health and providing hope to people living with liver disease."
• CATIE: "CATIE is Canada’s source for up-to-date, unbiased information about HIV and hepatitis C. We connect people living with HIV or hepatitis C, at-risk communities, healthcare providers and community organizations with the knowledge, resources and expertise to reduce transmission and improve quality of life."

Costs

• You should be able to find a free and confidential STI test in your area. For example, there are free STI tests at Willow Women's Clinic.

Medications & Vaccines

Laws & Social Stigmas

In 2016, Pre-Exposure Prophylaxis (PrEP)' was approved for usage in Canada (more details on access below).

What to Get & Where to Get It

• There are two HPV vaccines available in Canada: Cervarix® (HPV2) and Gardasil®9 (HPV9). For some people, the vaccine is free and, for other groups. it is available but not free. For example, the HPV9 vaccine is provided for free to all girls and boys in Canada in Grade 6. Other people who can get free HPV vaccines are girls born in 1994 or before who were not immunized, HIV-positive people (9-26 years of age), transgender people (9-26 years of age), men who have sex with men (9-26 years of age), men who are questioning their sexuality (9-26 years of age), and men who participate in street activity (9-26 years of age), and some other groups. You can visit the Immunize BC website to learn more.
• You can get the Hepatitis B vaccine at many sexual health clinics.
• If you want Post-exposure prophylaxis (PEP), you should contact a hospital emergency department or their doctor for treatment. Generally, no appointment is required since patients should be counseled and treated ASAP.
• If you want Pre-Exposure Prophylaxis (PrEP), it is available in Canada. In February 2016, Health Canada approved Truvada as prevention, and generic versions of TDF/FTC are approved for prevention. There are an estimated 900-1,100 people on PrEP in Canada, as of 2018. According to ACT Toronto, "Any doctor can prescribe PrEP. If you have a family doctor that you feel comfortable with, that is a good place to start. There is ongoing testing and medical care required with PrEP, so accessing PrEP through a doctor that you already have a connection with is ideal." CATIE has compiled extensive resources on PrEP for Canadians, which you can check out here. For updates on PrEP access in Canada, PrEPWatch is also a great resource.

Costs

• The HPV vaccine is free for some people (check out details in the above section).

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

You can easily finds pads and tampons in Canadian stores. If you want to buy a menstrual cup, you'll also find quite a few vendors. For DivaCup, check out Shoppers Drug Mart, PHARMAPLUS, Yonge Pharmacy, Nutrition House-Eaton Ctr Dund and Condom Shack. For MoonCup, you can deliver online. For Lunette, check out the Lunette North America website. For eco-friendly menstrual products, check out London Drugs, Loblaws, Save on Food, Whole Foods, Well.ca and Overwaitea.

Gynecological Exams

What to Get & Where to Get It

Note: There is a Canadian website called Pap Test Info: "Every year, almost 400,000 Canadian women receive a call that their Pap test result is abnormal. In many cases, the call is made by a nurse or medical receptionist who cannot discuss the results or implications over the phone. Often women are not given any information about what that means and are left feeling nervous or unsure about what happens next. This website has been developed to provide women with information about Pap testing and what it means to have abnormal test results. All of the information contained in this website has been reviewed by physicians."

• Vancouver General Hospital: Women's Clinic: "​The Women's Clinic offers diagnostic testing and treatment for women with pap smear abnormalities (pre-malignant cervical and vaginal lesions). A gynaecologic oncologist team also offers diagnosis and treatment of other pre-malignant conditions as well as other gynaecologic malignancies (i.e.. ovarian and endometrial cancer). Also provides services for diagnosing and treating vulvar skin conditions, vulvar pain and pre-malignant vulvar lesions. Also provides gynaecologic rapid-access services to ambulatory patients referred from the emergency department." Address: 2775 Laurel Street, 6th floor, station 4, Vancouver, BC, V5Z 1M9. Phone: (604) 875-5022. Fax: (604) 875-5807
• Everywoman's Health Centre: "Everywoman’s Health Centre is a Vancouver abortion and sexual health clinic which provides aspiration (surgical) abortion, medical abortions, IUD insertions, miscarriage management, and other reproductive health care. Our clinic provides these services in a supportive, non- judgmental, and confidential setting... To contact us call 604-322-6692. Please note: we are not a walk-in clinic. All appointments must be made by telephone."
• Willow Women's Clinic: "At Willow Women’s Clinic, we offer a range of services including medical abortions with Mifegymiso or Methotrexate, IUD insertion, emergency contraception, IUD removals, diaphragm and cervical cap fitting, endometrial biopsies and medical completion of miscarriage (spontaneous abortions)." Address: Suite 1013 – 750 West Broadway Vancouver BC V5Z 1H9. Ph. : 604-709-5611. Fax : 604-873-8304. Email: willowwomensclinic@yahoo.ca
• The Elizabeth Bagshaw Women’s Clinic: "In addition to abortion care, we provide pap tests, sexually transmitted infection testing and contraception services. This includes IUD management (IUD insertion, follow up and removal) as well as the sale of low-cost birth control." Address: Suite 200, 1177 West Broadway, Vancouver. Patient Line: 604-736-7878. Toll-free line: 1-877-736-7171.

Costs

• You can get free gynecological exams and pap smears at many clinics in British Columbia, such as the Willow Women's Clinic, if you have a valid BC Care Card.

Pregnancy

Laws & Social Stigmas

In British Columbia, government employees are entitled to 37 weeks of consecutive leave.

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Canada, abortion is legal at all stages of pregnancy with no restrictions. It is governed by the Canada Health Act. However, it should be noted that some reports indicate that third trimester abortions are not generally available.

Historically, there were significant challenges to abortion in the past. Until 1969, abortion was not generally legal. Following the Criminal Law Amendment Act, 1968-69, abortion became legal in cases where physicians decided the abortion was necessary for the physical or mental well-being of the woman. However, the Criminal Law Amendment Act also imposed restrictions on abortion access, as it was not generally accessible to all women. In 1988, the Supreme Court of Canada ruled that the existing abortion laws were illegal, and they were struck down. Since then, there have been no official laws on abortion in Canada, making it available to women without restrictions. Today, one-third of all hospitals in Canada perform abortions.

What to Get & Where to Get It

• Tip: You can call the Pregnancy Options Line (1-888-875-3163 throughout B.C. or 604-875-3163 from the Lower Mainland). This service provides information about abortion services, including counseling, for all B.C. residents.
• Everywoman's Health Centre: They provide medical abortions (after 9 weeks of pregnancy) and surgical abortions. "We respect women’s decisions. This clinic is run by the women who work here and we treat those who come to us the way we would want to be treated ourselves... To contact us call 604-322-6692. Please note: we are not a walk-in clinic. All appointments must be made by telephone."
• The Elizabeth Bagshaw Women’s Clinic: They offer medical and surgical abortions. Aspiration abortions are performed for up to 17 weeks of pregnancy. After 17 weeks of pregnancy, patients are referred to BC Women’s Hospital. "A doctor’s referral is not required to book an appointment with our clinic. Abortion care is paid for by the Medical Services Plan (CareCard) for BC residents who have current coverage; there will be fees for women without current coverage." Address: Suite 200, 1177 West Broadway, Vancouver. Patient Line: 604-736-7878. Toll-free line: 1-877-736-7171.
• Willow Women's Clinic: They currently provide medical abortions (for up to 10 weeks of pregnancy) with Mifegymiso or Methotrexate, but no surgical abortions (as of 2018). "ABORTIONS: We understand that the decision to end a pregnancy can be difficult. Our highly experienced doctors and counselors can provide you with the best care possible: confidential, supportive and non-judgmental in a physician’s office atmosphere." The cost is free if you have a valid BC Care Card. Address: Suite 1013 – 750 West Broadway Vancouver BC V5Z 1H9. Ph. : 604-709-5611. Fax : 604-873-8304. Email: willowwomensclinic@yahoo.ca
• CARE Program Women's Health Centre: This is an abortion provider, but the website seemed down when we tried to access it. Phone: +1 604-875-2022.

Costs

• Generally, abortions in Canada are funded by Medicare (for Canadian citizens and permanent residents). If you have a valid health card, medical and surgical abortions at free-standing clinics and hospitals are fully covered. However, you may need to pay a fee for pain medicines, which is typically around $30, as of 2018.
• If you're not a Canadian citizen or permanent resident, you'll need to pay between $300-$900 or an abortion at a free-standing clinic. The costs will vary, depending on how long you have been pregnant, the clinic and the type of procedure.
• If you need help paying for your abortion, call a local women's clinic to learn about your options.

Advocacy & Counseling

What to Get & Where to Get It

• The Kids Helpline: Call 1-800-668-6868. Toll-free, 24-hour, bilingual and anonymous phone counseling for teenagers and children.
• "Sex Sense is a toll free and confidential service offered to all residents of B.C. Got a question? We've got an answer! Call 1-800-739-7367 or go to sexsense.org to speak to a nurse, educator, or counsellor about sexual health, sexuality, contraception, clinic locations, or clinic referrals. Our line is open 9 am to 9 pm, Monday to Friday."
• Vancouver Women's Health Collective: "We at the Vancouver Women's Health Collective are a non-profit organization helping self-identified women foster health, wellness and equity through feminist approaches to advocacy, shared knowledge and low-barrier programs and services." Address: Vancouver Health Collective, 29 West Hastings Street, Vancouver, BC, V6B 1G4. Phone: 604-736-5262. Email: vwhc.centre@gmail.com

List of Additional Resources

• Sexual Health Information Line - Toll free: 1 (800) 668-2437; Local: (416) 392-2437. Hours of operation: Monday to Friday 10 am – 10:30 pm; Saturday and Sunday 11 am – 3pm
• The Sex Information and Education Council of Canada (SIECCAN): "The Sex Information and Education Council of Canada (SIECCAN) is a national registered charitable organization founded in 1964 to foster professional education and public knowledge about sexuality and sexual health. SIECCAN works with health professionals, educators, and community organizations to ensure that all Canadians have access to high quality sexual health information, education and related health and social services."
• Westcoast Women's Clinic for Hormone Health: "Westcoast Women's Clinic is one of the first physician-based clinics in British Columbia to be fully dedicated to hormone health and wellness. It was co-founded in 2001 by Dr. Bal Pawa and Dr. Nishi Dhawan. Both doctors are leading experts in hormonal medicine and are certified menopause clinicians by the North American Menopause Society." Address: 3525 West 4th Avenue. Telephone: 604-738-9601.
• Scarlett Teen: This website offers sex education to teenagers.
• Teen Health Source: This website offers sex education to teenagers.