PrEP Eligibility Based on HIV Status

PrEP ELIGIBILITY BASED ON HIV STATUS


HIV immunoassay blood test (rapid test if available)		Positive				▶	Consider HIV+ (pending confirmatory testing)
HIV immunoassay blood test (rapid test if available)						▶	Consider HIV+ (pending confirmatory testing)
Indeterminate	Negative or Indeterminate
▼
Signs/symptoms of acute HIV infection anytime in prior 4 weeks?		No				▶	HIV−
						▶	HIV−
	Yes
		▶	Option 1 Retest antibody in one month Defer PrEP decision
		▶

		▶	Option 2 (Preferred) Send blood for HIV antibody/antigen assay*		Positive	▶	HIV+
						▶	HIV+

					Negative	▶	HIV−
						▶	HIV−

		▶	Option 3 Send blood for HIV-1 viral load (VL) assay
		▶	Option 3 Send blood for HIV-1 viral load (VL) assay

				VL ≥3,000 copies/mL		▶	HIV+
Key:						▶	HIV+

HIV− Eligible for PrEP				VL <3,000 copies/mL		▶	Retest VL Defer PrEP decision
						▶	Retest VL Defer PrEP decision

HIV status unclear Defer PrEP decision				VL < level of detection WITHOUT signs/symptoms on day of blood draw		▶	HIV−
						▶	HIV−

HIV+ Not Eligible for PrEP				VL < level of detection WITH signs/symptoms on day of blood draw		▶	Retest in one month Defer PrEP decision
						▶	Retest in one month Defer PrEP decision

*Use only HIV antigen/antibody tests that are approved by FDA for diagnostic purposes.

REFERENCES

Centers for Disease Control and Prevention: US Public Health Service. Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2017 Update: A Clinical Practice Guideline. https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2017.pdf Published March 2018. Accessed June 10, 2020.

(Rev. 6/2020)

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