So, if you have someone who wants PrEP, the first step is to do the right HIV testing to make sure that they don’t have HIV.
HIV positivity is a contraindication to PrEP. So, probably the most important thing to remember is, if someone has a HIV test that’s positive, PrEP is not a complete regimen for treatment.
Also, it’s not just about HIV. It’s also about other sexually transmitted infections. And so make sure that you’re doing all the appropriate screening for viral hepatitis, so think about hep B, think about hep C, gonorrhea, chlamydia, syphilis.
And, it’s also a great time to step back and say, “Is my patient up to date with all their vaccines?” And, if they’re not, really start thinking about those as well. So whether it’s hepatitis or mpox, etcetera, make sure that they’re up to date.
Also important to get some baseline tests. So you may be looking at their kidney function, you’re gonna be looking potentially at their cholesterol levels. Once you have all that information, you start them on PrEP, and then you plan to see them again on a recurrent basis. So that you can continue to do HIV testing and monitor for any of the rare lab abnormalities that you can see with PrEP. Again, thinking about doing kidney function testing in some people. It varies by age, so check the guidelines out to see how often. And also thinking about doing cholesterol screenings for some people on certain PrEP medicines.
