HIV PrEP Overview and Testing Requirements

A medication taken by people who are HIV-negative to reduce their risk of getting infected with HIV.

A person who has a detectable or unknown viral load of HIV.

Not always using condoms during sex or not using condoms at all.

A sexually transmitted infection (STI) such as syphilis, gonorrhea, or chlamydia.

Men who have sex with men.

A medication regimen used to prevent HIV infection in people who are at risk.

A type of PrEP taken daily by mouth. It combines two antiretroviral drugs: emtricitabine (FTC) and tenofovir alafenamide (TAF).

A type of PrEP that involves injections of cabotegravir (CAB). It's administered by a healthcare provider every 2 months.

A negative HIV test within a week before starting PrEP is required, along with no signs or symptoms of acute HIV infection.

Before starting PrEP, a baseline assessment includes screening for STIs like syphilis, gonorrhea, and chlamydia, as well as hepatitis B and C for specific risk groups.

Hepatitis B serology is mandatory for all individuals starting PrEP. Hepatitis C serology is recommended particularly for men who have sex with men (MSM), transgender women (TGW), and people who inject drugs (PWID).

Renal function is assessed before starting PrEP, especially for people with existing kidney issues. Specific medications like emtricitabine (FTC) and tenofovir disoproxil fumarate (TDF) might not be suitable for individuals with reduced kidney function.

HIV tests (Ag/Ab and HIV-1 RNA assay) are conducted every 3 months during PrEP, along with assessing signs and symptoms of acute HIV infection, adherence to medication, and ongoing risk behaviors.

For all sexually active individuals on PrEP, STI screening is recommended at least every 3 months. Specific screenings for syphilis, gonorrhea, and chlamydia are tailored based on sexual orientation and risk factors.

Discussions about continuing or stopping PrEP therapy are held regularly during follow-up appointments. This helps to assess the patient's ongoing risk factors and the need for PrEP.

If a patient on PrEP tests positive for HIV, the results should be confirmed with appropriate laboratory testing.

Intramuscular (IM) cabotegravir (Apretude) may be more suitable for patients with significant kidney disease who have adherence issues with daily oral PrEP regimes.

For patients on emtricitabine (FTC) and tenofovir alafenamide (TAF), weight, triglyceride, and cholesterol levels should be assessed regularly.

PrEP therapy should be offered to patients when requested, even if no risk behavior is identified.