01_HIVTesting

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PREP SAFETY COUNSELLING MESSAGE:

HIV Testing

RELATED TO DAILY PREP


“PrEP is not sufficient for the treatment of HIV infection. HIV testing before starting or
restarting PrEP is essential to detect infections that require treatment. If PrEP is stopped, an
HIV test should be obtained before restarting it. Use of PrEP in people who already have
HIV infection can lead to development of resistance to PrEP medicines.”
WHO Implementation tool for pre-exposure prophylaxis (PrEP) of HIV infection. Module 1:
Clinical. Geneva: World Health Organization; 2017 (WHO/HIV/2017.17). Licence: CC BY-
NC-SA 3.0 IGO.

RELATED TO EVENT-DRIVEN PREP


“Monitoring visits and HIV testing and other laboratory testing for people taking PrEP should
be the same whether they take oral daily PrEP or event-driven PrEP. See the clinical module
(Module 1) in the WHO PrEP Implementation Tool (7). However, a man taking ED-PrEP
infrequently may not always need a new PrEP prescription as often as every three months,
or may be prescribed fewer bottles of PrEP. If that might be the case, counselling should
specifically emphasize testing for HIV every three months.”
“HIV testing is recommended every three months both for people taking daily oral and for
those taking ED-PrEP, usually coinciding with clients collecting their next prescription for
PrEP drugs. Some clinicians have raised concerns that drug resistance risk may be higher
with ED-PrEP because drug exposure is episodic and HIV testing may not occur before
PrEP use. People taking ED-PrEP infrequently may theoretically become HIV infected in
periods where they are off PrEP, with subsequent increased risk of resistance if ED-PrEP is
taken without prior HIV testing ruling out HIV infection.”
What’s the 2+1+1? Event-driven oral pre-exposure prophylaxis to prevent HIV for men who
have sex with men: Update to WHO’s recommendation on oral PrEP. Geneva: World Health
Organization; 2019 (WHO/CDS/HIV/19.8). Licence CC BY-NC-SA 3.0 IGO.

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