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It also outlines key medical, sexual, and substance-use history elements and baseline testing, including HIV testing, kidney function, and hepatitis screening.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/quick-clinical-guide-hiv-prep-updated-february-2020/401060/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/quick-clinical-guide-hiv-prep-updated-february-2020/401060.png","ImageObject",300,407,{"name":42,"@type":43},"EvelynWrites","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-27",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Which patients may benefit from HIV PrEP according to the guide?","Question",{"text":63,"@type":64},"HIV-negative individuals who ask for PrEP and people with HIV-positive partners may benefit. The guide also lists people with condomless anal sex, multiple or high-risk partners, transactional sex, recent bacterial STIs, and people who inject drugs or use stimulants such as methamphetamine during sex.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How should clinicians discuss PrEP with patients?",{"text":68,"@type":64},"The guide recommends being present and listening, asking about interest and readiness for PrEP, and exploring barriers and expected duration. It also emphasizes counseling patients on what to expect, including potential risks and benefits.",{"name":70,"@type":61,"acceptedAnswer":71},"What baseline testing is required before starting PrEP?",{"text":72,"@type":64},"All patients need a negative HIV antibody test using the 4th generation Ag/Ab approach prior to initiation. If acute HIV symptoms or a possible exposure in the last month are reported, testing should include both HIV RNA PCR viral load and HIV 4th generation Ag/Ab. Baseline evaluation also includes kidney function (serum creatinine with eGFR/CrCl) and hepatitis screening, including HBsAg and hepatitis C antibody.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},401060,1790817011,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":97,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},687212989558,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Quick Clinical Guide: HIV PrEP  \nPre-Exposure Prophylaxis  \nUpdated February 2020  \nPre-exposure prophylaxis (PrEP) is safe and effective for significantly reducing the risk of HIV infection in sexually active individuals and people who inject drugs (PWID). The U.S. Preventive Services Task Force has given PrEP Grade A status. This document is a brief “how-to guide,” including medication coverage options for California state, and links to patient assistance programs for lowincome patients. For resources and referrals, [go to](go to PleasePrEPMe.org. All web links are clickable in this document)[ PleasePrEPMe.org](go to PleasePrEPMe.org. All web links are clickable in this document)[. All web links are clickable in this document](go to PleasePrEPMe.org. All web links are clickable in this document).  \n1. Identify patients who may benefit from PrEP  \nHIV-negative individuals, including adolescents, men who have sex with men (MSM), cis-and transgender women, who may benefit from PrEP include:  \n• People who ask for PrEP  \n• People with HIV-positive partners  \n• People with sexual exposures including: condomless anal sex, multiple sex partners, sex partners at high risk for HIV, or transactional sex (such as sex for money, drugs or housing)  \n• People who have had a bacterial sexually transmitted infection (STI)  \n• People who inject drugs (PWID) and people who use stimulants, such as methamphetamine, during sex  \n2. Discuss PrEP with your patient  \nBe present and listen. Ask about interest in and readiness for PrEP:  \n• What do you know about PrEP? Do you know anyone on PrEP?  \n• What makes you want to start PrEP? What do you hope PrEP will do for you?  \n• What barriers do you foresee? How long do you foresee being on PrEP?  \nLet them know what to expect and about the potential risks and benefits of PrEP. Important points include:  \n\n| Adherence | Adherence is correlated with higher effectiveness. Tailor adherence strategies to patient needs and lifestyle (pillbox, phone or online reminders, cell phone alarms, etc.). Many people who inject drugs are capable of adhering to PrEP.\u003Cbr>• For rectal exposures, detectable drug blood levels equivalent to ≥4 doses/week are associated with a high level of protection. Several small studies suggest that feminizing hormones may lower tenofovir levels, but the clinical significance is unknown and additional study is needed on whether higher adherence is needed for protection for people taking feminizing hormones.\u003Cbr>• For vaginal/front exposures, detectable drug blood levels equivalent to 6-7 doses/week are associated with a high level of protection. |\n| --- | --- |\n| Time to protection | Time to maximum protection varies by site of exposure:\u003Cbr>• About 7 daily doses in rectal tissue. Note that there are alternatives to daily dosing that achieve protection in rectal tissue, such as “on-demand” 2-1-1 dosing (see page 3) .\u003Cbr>• About 21 daily doses in cervico-vaginal tissue, but don’t let this be a barrier to prescribing PrEP.\u003Cbr>• About 21 daily doses for blood exposures in people who inject drugs. |\n| Risk of resistance | Resistance to HIV medications can occur if acute HIV is not identified quickly while on PrEP. A negative HIV test result should be documented before initiating PrEP and every 3 months thereafter. Please counsel the patient to report immediately to clinic if they develop symptoms compatible with acute HIV infection (such as fever with sore throat, rash, or headache) . |\n\nPotential side PrEP is very well-tolerated. Nausea, abdominal discomfort, or headache is experienced in about 10% of effects people taking PrEP and usually resolves in a few weeks. Other side effects are rare (see page 3 for details).  \n3. Take a medical, sexual, substance use history and review of symptoms Check for:  \n• HIV exposures in the prior 72 hours; if present, offer post-exposure prophylaxis (PEP): [ebgtz.org/resource/pep-guide](ebgtz.org/resource/pep-guide)  \n• Recent symptoms of a mono-like illness","cbCaifbGDPkH05aW","https://ap.wps.com/l/cbCaifbGDPkH05aW","pdf",243150,"English","# Identify patients who may benefit from PrEP\n## Discuss PrEP with your patient\n## Take a medical, sexual, substance use history and review of symptoms\n## Obtain baseline testing","[{\"question\":\"Which patients may benefit from HIV PrEP according to the guide?\",\"answer\":\"HIV-negative individuals who ask for PrEP and people with HIV-positive partners may benefit. The guide also lists people with condomless anal sex, multiple or high-risk partners, transactional sex, recent bacterial STIs, and people who inject drugs or use stimulants such as methamphetamine during sex.\"},{\"question\":\"How should clinicians discuss PrEP with patients?\",\"answer\":\"The guide recommends being present and listening, asking about interest and readiness for PrEP, and exploring barriers and expected duration. It also emphasizes counseling patients on what to expect, including potential risks and benefits.\"},{\"question\":\"What baseline testing is required before starting PrEP?\",\"answer\":\"All patients need a negative HIV antibody test using the 4th generation Ag/Ab approach prior to initiation. If acute HIV symptoms or a possible exposure in the last month are reported, testing should include both HIV RNA PCR viral load and HIV 4th generation Ag/Ab. Baseline evaluation also includes kidney function (serum creatinine with eGFR/CrCl) and hepatitis screening, including HBsAg and hepatitis C antibody.\"}]","Quick Clinical Guide: HIV PrEP - Updated February 2020 | PDF",1790516312,13]