HIV_PrEP_Algorithm_Brochure

Q: What prerequisites must patients meet before starting oral or injectable PrEP?

Patients must have a documented negative HIV Ab/Ag test within 1 week, no signs or symptoms of acute HIV infection, an estimated creatine clearance at least 30 ml/min, and no contraindicated medications.

Q: How do the CDC testing algorithms handle cases where PrEP decision-making should be deferred?

If results are indeterminate (e.g., reactive Ab/Ag with non-detectable or conflicting HIV-1 RNA), the guidance directs confirmatory testing or retesting in 2–4 weeks, with PrEP decisions deferred until false positives are ruled out.

Q: What does the brochure recommend for laboratory monitoring while taking PrEP?

Laboratory testing is recommended prior to and during PrEP at multiple intervals, using CDC guidance to assess and confirm HIV-negative status and to identify potential negative side effects from medication.

Sep 27, 2026

Uploaded by Sophia Brooks

Brochure explains CDC guideline-recommended HIV PrEP testing pathways, aiming to simplify PrEP evaluation and ongoing monitoring. It highlights eligibility criteria and the use of PrEP testing algorithms with confirmatory HIV testing, including scenarios for oral/injectable PrEP timing and decision deferral when results are indeterminate. The document also outlines testing conditions (e.g., negative Ab/Ag, acute infection signs, creatinine clearance) plus recommended laboratory monitoring schedules and coding to support billing and reimbursement under the Affordable Care Act.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

PrEP Testing Simplification

Testing offerings and flexible options

Coverage and cost barrier reduction

Identifying eligible patients for PrEP initiation or continuation

CDC testing algorithms and confirmatory steps

Monitoring patients on PrEP

Recommended schedule of lab tests

Simplify the path to PrEP with CDC guideline-recommended testing PrEP medications could benefit an estimated 1. 2M people in the US, but fewer than 36% of them are taking such prescriptions.1 Quest offers flexible, reliable testing for PrEP Our HIV PrEP test offerings include all the mostrecent CDC guideline-recommended tests to determine clinical eligibility and to monitor patients while on PrEP. Test codes are now available to make testing simple and flexible to meet your patient’s needs. Flexible testing options so you can choose the right test based on your patient’s unique requirements Billing and reimbursement challenges mitigated by our updated menu offering Gender-inclusive testing language designed to cater to all your patients, regardless of gender Accessible testing options with approximately 2,000 Patient Service Centers and in-office phlebotomists to help patients get the tests they need, when they need them Eliminating cost barriersto PrEP testing and care The USPSTF issued a gradeA recommendation for prescribing PrEP for persons at increased risk of acquiring HIV. 2,3 Accordingly, under the Affordable Care Act, many plans, including the ones below, are required to cover PrEP and associated lab testing without cost-sharing.4 Non-grandfathered private health insurance plans Medicaid expansion plans Traditional Medicaid plansa Our tests are coded in alignment with these guidelines to help facilitate a smooth billing and reimbursement process for you and your patients. PrEP could help reduce the risk of getting HIV From sex by about 99%4 From injection drug use by at least 74%4 a Optional for adults, depending on state policy; however, preventive services for children are often covered as part of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit for children. Identify patients eligible for PrEP therapy initiation or continuation Updated CDC guidance states that all sexually active adults and adolescents, and/or persons who inject drugs, should receive information about PrEP and its role in reducing the risk of acquiring HIV.5 PrEP is particularly recommended for patients who report behaviors or circumstances that place them at substantial risk of exposure and infection, including5 • HIV-positive sexual or injection partner • Bacterial sexually transmitted infection in the past 6 months • History of inconsistent or no condom use with sexual partner(s) Patients must meet several conditions prior to beginning oral or injectable PrEP.5 • Documented negative HIV Ab/Ag test result within 1 week before initially prescribing PrEP • No signs/symptoms of acute HIV infection • Estimated creatine clearance ≥30 ml/minb • No contraindicated medications The updated CDC guidelines feature 2 testing algorithms that include confirmatory HIV testing as part of a baseline assessment for patients beginning or continuing PrEP.5 If the patient has not taken oral PrEP or PEP medication in the past 3 months AND has not received a cabotegravir injection in the past 12 months HIV HIV-Eligible for PrEP HIV + Not eligible for PrEPc HIV status unclear. Defer PrEP decision - HIV + HIV-1 RNA ≥200 copies/mL HIV + HIV - and / or HIV - Send plasma for HIV antibody/antigen assay No Nonreactive (negative) HIV-1 RNA detectable but <200 copies/mL HIV-1 RNA < level of detection no signs/symptoms on day of blood draw HIV-1 RNA < level of detection with signs/symptoms on day of blood draw Retest in 2-4 weeks. Defer PrEP decision; consider PEP Draw new plasma specimen Defer PrEP decision until false positive ruled out Yes Reported HIV exposure-prone event in prior 4 weeks AND signs/symptoms of acute HIV infection at any time in prior 4 weeks Send plasma for qualitative HIV-1 RNA assay (TC 13600) c HIV-1 positive individuals may not be eligible for PrEP or, if on PrEP, consider alternative patient management. Pleas

FAQs

What prerequisites must patients meet before starting oral or injectable PrEP?

Patients must have a documented negative HIV Ab/Ag test within 1 week, no signs or symptoms of acute HIV infection, an estimated creatine clearance at least 30 ml/min, and no contraindicated medications.

How do the CDC testing algorithms handle cases where PrEP decision-making should be deferred?

If results are indeterminate (e.g., reactive Ab/Ag with non-detectable or conflicting HIV-1 RNA), the guidance directs confirmatory testing or retesting in 2–4 weeks, with PrEP decisions deferred until false positives are ruled out.

What does the brochure recommend for laboratory monitoring while taking PrEP?

Laboratory testing is recommended prior to and during PrEP at multiple intervals, using CDC guidance to assess and confirm HIV-negative status and to identify potential negative side effects from medication.

Sep 27, 2026

Uploaded by Sophia Brooks