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

1. F/TDF (Truvada): eCrCl must be ≥ 60ml/min
   F/TAF (Descovy): eCrCl must be ≥ 30ml/min
2. F/TDF (Truvada): adefovir
   F/TAF (Descovy): St. John’s Wort, rifampin, rifabutin, rifapentine
   CAB (Apretude): rifampicin, rifapentine, carbamazepine, oxcarbazepine, phenytoin, phenobarbital
3. Substantial risk of HIV acquisition in the past 72 hours
4. 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.
5. Substantial HIV-exposure event AND symptoms of ARS unexplained by a more likely diagnosis in the past 4 weeks