HIV PrEP Overview and Testing Requirements

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Questions and Answers

What recent behavioral history may qualify an individual for HIV Pre-Exposure Prophylaxis (PrEP)?

Consistent condom use with any partner

Solely the use of non-injection recreational drugs

Absence of any bacterial STI diagnosis in the past year

Having had sex with a partner who is a known HIV carrier (correct)

Which condition is NOT mentioned as a consideration for evaluating eligibility for PrEP?

Injectable drug use

Previous use of oral contraceptives (correct)

History of one or more bacterial STIs in the last 6 months

Inconsistent condom use

Which group is specifically highlighted concerning eligibility requirements for PrEP based on bacterial STI diagnoses?

Only heterosexual women

Individuals in monogamous relationships

Men who have sex with men (MSM) and transgender women (TGW) (correct)

All genders equally

What is a significant reason individuals may hesitate to discuss their sexual history with healthcare providers regarding PrEP?

Fear of being judged based on their lifestyle Signup and view all the answers

Which statement best describes the target group for HIV PrEP eligibility concerning drug use?

People who have used injectable drugs recreationally Signup and view all the answers

What is the initial dosing schedule for Intramuscular Cabotegravir?

600 mg IM injection one month apart after two initial doses Signup and view all the answers

Which PrEP regimen requires a negative eCrCl of at least 30 mL/min?

FTC + TAF Signup and view all the answers

What is the recommended follow-up testing frequency for renal function in patients over 50 years?

Every 6 months Signup and view all the answers

What additional screening is specifically recommended for MSM and TGW during routine follow-up?

Syphilis, gonorrhea, and chlamydia screening Signup and view all the answers

How often should patients receiving oral PrEP be tested for HIV?

Every 3 months Signup and view all the answers

What is the maintenance dosing schedule for Cabotegravir after initial injections?

600 mg every 2 months Signup and view all the answers

For which population is it preferred to administer IM Cabotegravir due to renal issues?

Patients with significant renal disease Signup and view all the answers

What is the critical screening that must be done within 1 week before initiating PrEP therapy?

HIV test (Ag/Ab) Signup and view all the answers

How often must STI screening occur for all sexually active patients on PrEP?

Every 3 months Signup and view all the answers

What is the optional oral lead-in period for starting Cabotegravir therapy?

28 days of oral doses Signup and view all the answers

Which PrEP regimen can lead to severe renal impairment if not monitored properly?

FTC + TAF Signup and view all the answers

What specific health history should be taken into consideration when evaluating suitability for oral PrEP?

Renal function and previous STI status Signup and view all the answers

HIV testing should occur following the positive result during PrEP therapy for confirmation. What laboratory test should confirm the result?

Confirmatory laboratory testing for HIV Signup and view all the answers

Which parameter is not part of the routine follow-up for patients on oral PrEP?

Vision tests Signup and view all the answers

Study Notes

HIV Pre-Exposure Prophylaxis (PrEP)

PrEP is a strategy to prevent HIV infection
PrEP regimens include oral and intramuscular options
Oral PrEP regimens:
- Emtricitabine (FTC) + Tenofovir alafenamide (TAF) (Descovy)
- Emtricitabine (FTC) + Tenofovir disoproxil fumarate (TDF) (Truvada)
- Dosing: once daily by mouth
Intramuscular PrEP:
- Cabotegravir (CAB)
- Dosing: 600mg injection every 2 months
- Initial dosing: 2 injections, one month apart
- Oral lead-in option: 30mg cabotegravir daily for 28 days, then first injection
Baseline screening and testing:
- Negative HIV test (Ag/Ab) within 1 week before initiation
- No signs/symptoms of acute HIV infection
- Hepatitis B and C serology
- Renal function tests
- STI screening (syphilis, gonorrhea, chlamydia)
  - Specific tests depending on risk factors (e.g., MSM, transgender women, etc.)
Follow-up testing:
- Oral PrEP: Every 3 months, assess for signs/symptoms of acute HIV, adherence and risk engagement behavior. MSM and TGW screen for sexually transmitted infections every 6 months. Every 12 months assessment of renal function, and assess for hepatitis C, chlamydia, syphilis in all patients
- IM PrEP: One month after first injection: HIV testing, signs of acute infection. Every 2 months (starting on month 3): HIV testing, signs of acute infection. Every 4 months (starting month 3): STI testing (MSM & TGW screen for syphilis, gonorrhea, and chlamydia. Heterosexual men & women screen for syphilis and gonorrhea. Every 12 months, after the first injection—discuss continuation of PrEP therapy assess for chlamydia.
Eligibility criteria:
- Individuals at risk for HIV infection and who meet specific criteria, including sexual history and injection drug use

Abbreviations

TAF: tenofovir alafenamide
TDF: tenofovir disoproxil fumarate
FTC: emtricitabine
CAB: cabotegravir
MSM: men who have sex with men
TGW: transgender women
PWID: people who inject drugs
STI: sexually transmitted infection

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Description

Explore the essential aspects of HIV Pre-Exposure Prophylaxis (PrEP) in this quiz. You'll learn about the different regimens, including oral and intramuscular options, as well as the key baseline and follow-up screening requirements necessary for effective PrEP management.