PrEP Provider Toolkit

Patient Eligibility

Contraindications for Pre-Exposure Prophylaxis
PrEP is not indicated if ANY of the following applies: Is <12 years old Weighs <35 kg (77 lbs) Does not meet the required eCrCl cutoffs¹ Takes severely contraindicated drugs² Has an indication for HIV post-exposure prophylaxis (PEP)³ HIV+ or HIV unknown⁴ High clinical suspicion for acute HIV infection⁵ Injectable CAB (Apretude) cannot be used in those with buttock implants or fillers
Footnotes F/TDF (Truvada): eCrCl must be ≥ 60ml/min F/TAF (Descovy): eCrCl must be ≥ 30ml/min F/TDF (Truvada): adefovir F/TAF (Descovy): St. John’s Wort, rifampin, rifabutin, rifapentine CAB (Apretude): rifampicin, rifapentine, carbamazepine, oxcarbazepine, phenytoin, phenobarbital Substantial risk of HIV acquisition in the past 72 hours Requires a negative lab-based 4th-gen HIV Ag/Ab test OR POC HIV Ag/Ab test (Abbott Determine). If the patient has been on oral PrEP/PEP in the past 3 months or injectable PrEP in the past year, also needs a negative HIV-RNA test in the past week. Oral fluid tests or HIV-Ab only POC tests are not recommended. Substantial HIV-exposure event AND symptoms of ARS unexplained by a more likely diagnosis in the past 4 weeks
Table 2. Contraindications to utilize PrEP

Contraindications for Pre-Exposure Prophylaxis

PrEP is not indicated if ANY of the following applies:

Is <12 years old
Weighs <35 kg (77 lbs)
Does not meet the required eCrCl cutoffs¹
Takes severely contraindicated drugs²
Has an indication for HIV post-exposure prophylaxis (PEP)³
HIV+ or HIV unknown⁴
High clinical suspicion for acute HIV infection⁵
Injectable CAB (Apretude) cannot be used in those with buttock implants or fillers

Footnotes

F/TDF (Truvada): eCrCl must be ≥ 60ml/min
F/TAF (Descovy): eCrCl must be ≥ 30ml/min
F/TDF (Truvada): adefovir
F/TAF (Descovy): St. John’s Wort, rifampin, rifabutin, rifapentine
CAB (Apretude): rifampicin, rifapentine, carbamazepine, oxcarbazepine, phenytoin, phenobarbital
Substantial risk of HIV acquisition in the past 72 hours
Requires a negative lab-based 4th-gen HIV Ag/Ab test OR POC HIV Ag/Ab test (Abbott Determine).
If the patient has been on oral PrEP/PEP in the past 3 months or injectable PrEP in the past year, also needs a negative HIV-RNA test in the past week.
Oral fluid tests or HIV-Ab only POC tests are not recommended.
Substantial HIV-exposure event AND symptoms of ARS unexplained by a more likely diagnosis in the past 4 weeks

Table 2. Contraindications to utilize PrEP