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<sup>1</sup> Clinicians should determine if the HIV-neg pt knows if the HIV-positive partner is receiving ART and whether a recent eval indicates an undetectable viral load.<br><br>
<sup>2</sup> Document a negative Ab test result w/in the wk before initiating (or reinitiating) PrEP meds, ideally w/ an Ag/Ab test conducted by a lab whenever available.<br><br>
Two options:<br>
1) Draw blood (serum) and send specimen to lab for Ag/Ab test or Ab-only test OR<br>
2) perform rapid, point-of-care FDA-approved fingerstick blood test.</br><br>
Don’t use rapid tests that use oral fluids to screen for HIV infxn as they can be less sensitive than blood tests.<br><br>
Note: If using viral load testing, be aware that available assays might yield false positive low viral load results (<3,000 copies/mL) among persons w/o HIV infxn.<br><br>
See <a href=http://www.cdc.gov/hiv/testing/laboratorytests.html><b><u>FDA-approved HIV tests</u></b></a>, specimen requirements, and time to detection of HIV infxn.
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<sup>3</sup> Don’t start PrEP if eCrCl <60 mL/min. Recheck renal status at 3mo, and q6mo thereafter. D/C PrEP if renal failure detected [IIIA].
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<sup>4</sup> HBV infxn isn’t a contraindication to PrEP use. CDC recommends vaccinating all adults/adolescents at substantial risk for HIV infx against HBV, especially MSM. Document HBV infxn status by screening seriology before prescribing TDF/FTC. Vaccinate pts determined to be susceptible to HBV infxn. If pt is HBsAg positive, treat or refer to experienced HBV care provider.
<br><br>
<sup>5</sup> Use of antiretrovirals other than TDF/FTC (or TDF) is <b>not</b> recommended [IIIA], incl 3TC, TAF, either in place of, or in addition to TDF/FTC (or TDF). Prescription of oral PrEP for coitally timed or other noncontinuous daily use is <b>not</b> recommended [IIIA].
<br><br>
No data exist on PrEP regimen effectiveness in PWID.
<br><br>
<sup>6</sup> TDF/FTC alone is inadequate tx for established HIV infxn, & its use may lead to drug resistance [IA].
<sup>2</sup> Document a negative Ab test result w/in the wk before initiating (or reinitiating) PrEP meds, ideally w/ an Ag/Ab test conducted by a lab whenever available.<br><br>
Two options:<br>
1) Draw blood (serum) and send specimen to lab for Ag/Ab test or Ab-only test OR<br>
2) perform rapid, point-of-care FDA-approved fingerstick blood test.</br><br>
Don’t use rapid tests that use oral fluids to screen for HIV infxn as they can be less sensitive than blood tests.<br><br>
Note: If using viral load testing, be aware that available assays might yield false positive low viral load results (<3,000 copies/mL) among persons w/o HIV infxn.<br><br>
See <a href=http://www.cdc.gov/hiv/testing/laboratorytests.html><b><u>FDA-approved HIV tests</u></b></a>, specimen requirements, and time to detection of HIV infxn.
<br><br>
<sup>3</sup> Don’t start PrEP if eCrCl <60 mL/min. Recheck renal status at 3mo, and q6mo thereafter. D/C PrEP if renal failure detected [IIIA].
<br><br>
<sup>4</sup> HBV infxn isn’t a contraindication to PrEP use. CDC recommends vaccinating all adults/adolescents at substantial risk for HIV infx against HBV, especially MSM. Document HBV infxn status by screening seriology before prescribing TDF/FTC. Vaccinate pts determined to be susceptible to HBV infxn. If pt is HBsAg positive, treat or refer to experienced HBV care provider.
<br><br>
<sup>5</sup> Use of antiretrovirals other than TDF/FTC (or TDF) is <b>not</b> recommended [IIIA], incl 3TC, TAF, either in place of, or in addition to TDF/FTC (or TDF). Prescription of oral PrEP for coitally timed or other noncontinuous daily use is <b>not</b> recommended [IIIA].
<br><br>
No data exist on PrEP regimen effectiveness in PWID.
<br><br>
<sup>6</sup> TDF/FTC alone is inadequate tx for established HIV infxn, & its use may lead to drug resistance [IA].
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Risk criteria: HIV+ injecting partner,<sup>1</sup> sharing injxn equipment