Montréal

Canada / Quebec / Montreal

SURVOL

À Montréal, vous aurez de nombreux choix de services de soins de santé. Les méthodes contraceptives, notamment les préservatifs, les pilules, les timbres et les injections, sont facilement accessibles. Ces méthodes contraceptives ne sont toutefois généralement pas remboursées par le système de santé canadien, du moins pas pour tous. Vous trouverez néanmoins des pilules et stérilets à moindre coût dans les cliniques publiques. Vous pouvez vous procurer la pilule contraceptive d'urgence ("pilule du lendemain") à la pharmacie (au comptoir du pharmacien, sans ordonnance) ou dans une clinique de santé sexuelle. Il n'y a pas d'âge minimal requis, mais la vente reste à la discrétion du pharmacien. De nombreuses cliniques publiques de santé sexuelle offrent des tests de dépistages des ITS. Certaines cliniques offrent tous les tests gratuitement alors que d'autres le font seulement pour le VIH, mais la plupart exigent des frais de consultation. Il est recommandé de prendre rendez-vous. Un programme de vaccination contre le VPH est également offert. La prophylaxie pré ou post-exposition (PrEP) est disponible. Les avortements sont légaux au Canada et aucune contrainte n'existe en théorie. Avec une carte valide de la Régie de l'assurance-maladie du Québec (RAMQ), l'intervention par médicament ou par instrument est totalement gratuite.

Contraception

Note: Il existe de nombreuses méthodes contraceptives, notamment le DIU (dispositif intra-utérin ou stérilet), le contraceptif oral ("la pilule"), le timbres, l'anneau vaginal, l'injection et le préservatif. Pour une liste plus exhaustive et des explications, cliquez ici

Lois et stigmatisation sociale

Au Canada, vous trouverez des préservatifs dans de nombreux magasins, notamment dans les pharmacies et plusieurs dépanneurs (épicerie de quartier). Pour les autres contraceptifs, tels que la pilule, le stérilet, l'injection ou l'implant, il faut l'ordonnance d'un médecin ou d'une infirmière.

De manière générale, l'usage de contraceptifs est assez répandu dans tout le pays. On estime que plus de 70 % des femmes en âge de procréer utilisent une méthode de contraception moderne, et environ 22 % des hommes ont subi une vasectomie. Malgré tout, l'accès aux différentes méthodes n'est pas toujours sans difficulté pour les femmes. La Société des obstétriciens et gynécologues du Canada estime que les Canadiennes ont, de manière générale, moins facilement accès à la contraception que les femmes des autres pays développés. De plus, selon le rapport du Groupe d'étude canadien sur les soins de santé préventifs, 15 % des femmes sexuellement actives n'utilisent aucune méthode contraceptive, et 20 % le font de manière irrégulière. Le coût peut être une contrainte, quand on sait que les contraceptifs ne sont pas totalement remboursés par le système de santé public canadien. Néanmoins, des contraceptifs abordables sont offerts dans les cliniques de santé sexuelle (qui peuvent toutefois avoir une choix limité, des heures d'ouverture restreintes et de longs temps d'attente). Malgré ces quelques failles, ces cliniques demeurent une ressource incontournable pour la santé reproductive des femmes (et de hommes).

Quoi se procurer et où se le procurer

• Vous pouvez acheter des préservatifs en ligne à Top Condoms Canada, IdealCondoms.ca et à Undercover Condoms. Il est aussi possible de se les procurer en pharmacie ou dans plusieurs dépanneurs (épicerie de quartier).
• Vous pouvez vous procurer des contraceptifs oraux avec une prescription à la pharmacie ou à la clinique médicale.
• Si vous voulez un DIU, il est possible de vous en procurer à de nombreuses cliniques ou CLSC (Centre local de services communautaires). Par exemple, le DIU Mona Lisa est disponible au Centre de santé des femmes de Montréal et les implants Mirena sont offerts à la Clinique médicale Fémina.
• Des injections de type Depo-Provera sont aussi offerts à la Clinique médicale Fémina.

Coûts

Bien que le Canada ait un système de santé universel, les contraceptifs ne sont pas gratuits. Il peuvent être offerts à prix réduit si vous êtes sous le régime de la RAMQ. Différentes options à prix abordable sont toutefois offertes dans les cliniques de santé sexuelle. Par exemple, le prix des contraceptifs oraux de base peut aller jusqu'à 10 $ pour une plaquette d'un mois, et les DIU peuvent coûter 60 $ environ. Les prix sont plus élevés dans les cliniques privées, où le stérilet Mona Lisa coûte environ 55 $, le Jaydess autour de 300 $ et le Mirena entre 360 et 380 $.

Contraception d'urgence ("pilule du lendemain")

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. 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. For general information on emergency contraceptives, click here and here.

Lois et stigmatisation sociale

Au Canada, les contraceptifs d'urgence (ou "pilule du lendemain") sont disponibles à la pharmacie, mais ne sont pas en vente libre. Il faut s'adresser au pharmacien, même si aucune ordonnance médicale n'est requise. On les retrouve aussi dans les hôpitaux.

There are 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

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 2 pills 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).

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.

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

Check out this list of STI testing sites in Montreal,

• Medical Clinic L'Actuel: Provides HIV test (including rapid test), along with other STI test. There's a $20 fee. They also have PEP. Address : 1001, boul. De Maisonneuve Est, Suite 1130, Montreal, H2L 4P9. Phone : 514-524-1001.
• Medical clinic L'Alternative: Address : 2034, rue Saint-Hubert, Montreal, H2X 3Z5. Phone : 514-281-9848.
• Medical Clinic of the Latin Quarter: Address : 905, boul. René Lévesque East, Montreal. Phone : 514-285-5500.
• CLSC service points Outskirts: Telephone : 514-527-2361
  • 1705 Visitation Street, Montreal, H2X 3C3
  • 1250 Sanguinet Street, Montreal, H2X 3E7
  • 2260 Parthenais, Montreal, H2K 3T5
• Jewish General Hospital Infectious Diseases and STIs Walk in clinic (Côte-des-Neiges): Monday to Friday, 7:30 a.m. – 10:30 a.m.. Walk-in only. Phone: 514-340-8230
• CSSS Jeanne-Mance - Street Youth Clinic: Address 1 - CLSC suburbs : 1250 Sanguinet Street, Montreal, H2X 3E7 Telephone : 514-527-9565, ext 3682. Address 2 - Ketch Café : 4707, rue St-Denis, Montreal. Phone : 514-985-0505.
• CSSS of the Mountain - CLSC Métro: Address : 1801 boul. de Maisonneuve W., Montreal, H3B 1J9 (Guy-Concordia Metro). Phone : 514-934-0354.
• Coeur-de-l'Île CSSS - CLSC Villeray: The tests are NOT anonymous here. Address : 1415 Jarry East. Montreal, H2E 1A7. Phone : 514-376-4141.
• Rezo: They provide HIV tests for gay and bisexual men who are cis and trans.

Support

• 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."
• Maison du Parc: "A not-for-profit organization, the Maison du Parc welcomes men and women stricken with HIV/AIDS. It offers a palliative care program and accompaniment for the physical, psychological and social needs of our residents."

Medications & Vaccines

Laws & Social Stigmas

PrEP was approved for usage in 2016.

What to Get & Where to Get It

• 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.
• Pre-Exposure Prophylaxis (PrEP) is available in Canada. In February 2016, Health Canada approved Truvada as prevention. 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 also compiled extensive resources on PrEP for Canadians, which you can check out here.

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

For information on gynecologists in Canada, please visit the city pages, like the Toronto page, as recommendations will vary by city.

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."

Pregnancy

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 and, in Quebec, it's fully permitted for up to 22 weeks of pregnancy.

Canadian abortion laws are 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

• Clinique médicale Fémina: Provides surgical abortions. "Clinique médicale Fémina is a well known clinic offering abortion services during the first trimester of pregnancy since 1988." Only one visit needed for pregnancies under 12 weeks.
• Morgentaler Clinic Montreal: Provides surgical abortions. "Services are available by appointment only. Pregnancy terminations are performed up to 18 weeks of pregnancy. Only one visit to the clinic is required for the first trimester procedure, including counselling and ultrasound. Second trimester pregnancy terminations (between 13 and 18 weeks) require preparation and may require one or two pre-procedure visits."
• Le Centre de santé des femmes de Montréal : Provides surgical abortions. With a feminist approach, the Centre de santé des femmes de Montréal is offering abortion services in one visit, by appointment only.

Costs

• Generally, abortions in Canada are funded by Medicare (for Canadian citizens and permanent residents). If you have a valid Quebec health insurance card (RAMQ), medical and surgical abortions at free-standing clinics and hospitals are fully covered.
• 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 in Toronto, call Planned Parenthood Toronto (416-961-0113) or the Bay Centre for Birth Control (416-351-3700) 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.
• L’Association québécoise de prévention du suicide: A 24/7 distress line serving Quebec. Call 1-866-277-3553 (1-866-APPELLE).
• ATQ (Aide aux transexuels et transexuelles du Québec): Offers a listening line for transgendered individuals in Quebec. Call 514-254-9038.
• Project 10 (Projet 10): "Promotes personal, social, sexual, and mental well-being of lesbian, gay, bisexual, transgender, transsexual, two-spirit, inter-sexed, and questioning youth and adults ages 14-25. Offers a listening line on Monday to Thursday from 12pm to 6pm. Call 514-989-4585."
• Distress Line 416-408-HELP (4357): Provides telephone support for people facing crisis situations and suicide prevention.

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
• National Council for Women of Canada: "Throughout its history, the Council has been concerned with the welfare and improvement of the conditions of life for women, the family, and the community since its founding."
• CCGLM: "The Community centre for gay and lesbians of Montreal is a non-profit organization which was established on August 17, 1988. The CCGLM acts to improve the well-being of people in our communities by promoting cooperation and seeking the support of the community and social development by individuals and organizations."
• 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."
• Scarlett Teen: This website offers sex education to teenagers.
• Teen Health Source: This website offers sex education to teenagers.
• Institue for Gender, Sexuality and Feminist Studies at McGill: 3487 Peel Street, 2nd floor, Montreal, Quebec H3A 1W7, Tel.: 514-398-3911, Fax: 514-398-3986. Email: info.igsf@mcgill.ca