PrEP Eligibility Based on HIV Status

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PrEP ELIGIBILITY BASED ON HIV STATUS
                     
  HIV immunoassay blood test (rapid test if available)  Positive Consider HIV+ (pending
confirmatory testing)
 
           
  Indeterminate  
Negative or
Indeterminate
 
         
       
  Signs/symptoms of acute HIV infection anytime in prior 4 weeks?  
No
 
HIV−    
 
     
Yes
 
       
     
 
 
Option 1
Retest antibody in one month
Defer PrEP decision
 
   
   
      Option 2 (Preferred)
Send blood for HIV antibody/antigen assay*
Positive HIV+  
 
     
      Negative HIV−  
 
     
     
 
 
Option 3
Send blood for
HIV-1 viral load (VL) assay
 
         
          VL ≥3,000 copies/mL HIV+
  Key:      
         
  HIV−
Eligible for PrEP
    VL <3,000 copies/mL  
Retest VL
Defer PrEP decision
         
         
  HIV status Unclear
Defer PrEP decision
    VL < level of detection
no signs/symptoms on day of blood draw
 
 
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
 
                   

*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/guidelines/cdc-hiv-prep-guidelines-2017.pdf. Published March 2018. Accessed April 19, 2018.

(Rev. 4/2018)

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