Suggested evaluation at baseline and during pre-exposure prophylaxis
| Assay type | Baseline | 30 d | Q 3 mo | Q 12 mo |
|---|---|---|---|---|
| Laboratory evaluation | ||||
| HIV testing* | X | X | X | |
| Hepatitis A immunity (hepatitis A total antibody)† | X | |||
| Hepatitis B screen (surface antigen, surface antibody, core antibody)†‡ | X | X† | ||
| Hepatitis C antibody | X | X | ||
| Screening for gonorrhea and chlamydia§ (urine nucleic acid amplification test, throat and rectal swabs for culture or nucleic acid amplification; test anatomic sites depending on type of sexual activity reported) | X | X | ||
| Syphilis serology§ | X | X | ||
| Complete blood count | X | |||
| Creatinine | X | X | X | |
| Urinalysis | X | |||
| Pregnancy test (as appropriate) | X | X | ||
| Clinical evaluation | ||||
| Symptoms of HIV seroconversion | X | X | X | |
| PrEP adherence | X | X | ||
| Indication for PrEP | X | X | X | |
| Use of other HIV and STI prevention strategies | X | X | X | |
| Presence and management of syndemic conditions | X | X | X | |
Note: PrEP = pre-exposure prophylaxis, STI = sexually transmitted infection.
↵* Preferred HIV test is a 4th-generation antibody/antigen combo assay. Those with signs or symptoms of acute HIV should also undergo HIV RNA or pooled nucleic acid amplification test.
↵† Hepatitis A and/or B vaccine should be initiated in unvaccinated individuals. Those who remain nonimmune to hepatitis B virus should be rescreened annually.
↵‡ Individuals with chronic active hepatitis B should be managed in consultation with an expert on hepatitis B virus according to Canadian guidelines.
↵§ Individuals who have STIs should be offered standard therapy and follow-up as per local guidelines.