PrEP Evaluation
Adults 18 and older can discuss here whether HIV PrEP might fit. PrEP is pills or shots used before a possible exposure by someone without HIV. It reduces the chance of HIV from sex or shared injection equipment. It does not treat HIV or prevent other infections or pregnancy. Prescribing and a confirmed outside program are not established. Exposure within 72 hours needs emergency PEP now. PrEP is not PEP.
Symptoms and questions to discuss
- No symptoms, which is common at a PrEP discussion
- A recent bacterial STI, or a partner who has HIV
- Sex without condoms with partners of unknown HIV status
- Shared injection equipment, not treated here as substance-use care
What we check
- Anal or vaginal sex in the past 6 months, and condom use
- A partner with HIV and whether the viral load is known
- A recent bacterial STI, and which one
- Injection exposure, possible pregnancy, and medicine already in use
- Recent PEP, missed doses, a flu-like illness, or exposure within 72 hours
Treatment options by class
Your provider reviews appropriate options and follow-up based on your assessment.
- Documented negative HIV testing selected for the regimen and recent use before starting
- Virus-detection testing after recent oral PrEP, recent PEP, or a long-acting shot
- External kidney, hepatitis B, lipid, pregnancy, or STI tests when that option needs them
- HIV testing and follow-up on the outside prescribing provider’s regimen-specific schedule
- Condoms, because PrEP does not cover pregnancy or other infections
When we refer
Within 72 hours of possible HIV exposure, go to an emergency room now for PEP. Do not wait for this visit. This program does not prescribe PEP or PrEP and does not treat substance use. Missed doses plus a new exposure need urgent evaluation now. Sudden severe testicular or severe pelvic/abdominal pain needs emergency assessment even without fever. Sexual assault needs the emergency room. No forensic exam is done here. Pregnancy care stays outside this program. Under 18, use another setting. No PrEP program is confirmed.
How fit is discussed
Discuss PrEP if you do not have HIV and had anal or vaginal sex in the past 6 months plus a partner with HIV, a recent bacterial STI, or condomless sex with partners of unknown HIV status. Count syphilis, gonorrhea, or chlamydia for men who have sex with men and transgender women. Heterosexual guidelines name gonorrhea and syphilis. Shared injection equipment is separate. This visit does not treat substance use. You may still ask. The age floor is 18.
What cannot start here
This pathway discusses assessment, not local PrEP prescribing. Confirm access to an outside prescribing provider. HIV testing must exclude infection before starting; the selected regimen and recent PrEP or PEP use determine whether virus-detection testing is also needed. Acute illness after exposure needs evaluation first. Kidney, hepatitis B, lipid, pregnancy, and STI tests are selected according to the option and your circumstances through outside services. Do not start leftover pills or shots yourself.
Who owns follow-up
HIV testing, STI screening, and follow-up depend on regimen, exposure, and risk. An outside prescribing provider sets the schedule, including refills, injections, and response to missed doses. Current options include daily oral prevention and injectable options with different intervals, including a six-month option. Do not assume one testing interval fits all. Confirm who reviews results and remains responsible while access is pending. Onset of protection depends on the selected option and exposure type; follow that provider’s instructions.
PEP first, then PrEP
PEP is emergency care within 72 hours after exposure, because HIV often takes hold in 24-36 hours. It is not used later. Do not use a mouth-swab test or delay the first dose for labs. A course is about 28 days. Discuss PrEP only afterward if exposure will continue. Do not switch during PEP. This visit starts neither.
Frequently asked questions
Is PrEP the same as PEP?
No. PrEP comes before a possible future exposure in someone without HIV. PEP is emergency medicine after an exposure and cannot wait for this visit.
Can I get PrEP at this clinic?
No. Prescribing and a confirmed outside program are not established.
How soon might PrEP protect?
Timing depends on the option and exposure. CDC describes about 7 days of daily oral dosing for receptive anal sex and up to about 21 days for receptive vaginal sex or injection exposure. Those estimates do not apply to every regimen. Follow the prescribing provider’s plan.
Which test is required first?
HIV testing must exclude infection before PrEP. The selected option and recent prevention use determine which blood tests are needed, including virus detection in some circumstances. Other baseline tests depend on the regimen. Confirm the outside ordering provider and who reviews each result.
I missed doses and may have been exposed. What now?
Seek urgent care now if a new exposure follows missed doses. If it was within 72 hours, go to emergency care for PEP evaluation without waiting for this appointment. Do not start leftover pills or substitute PrEP for PEP.
Sources
- Prevention of Acquisition of HIV: Preexposure Prophylaxis — U.S. Preventive Services Task Force
- Preventing HIV with PrEP — Centers for Disease Control and Prevention
- Clinical Guidance for PEP — Centers for Disease Control and Prevention
- Human Immunodeficiency Virus (HIV) Infection: Screening — U.S. Preventive Services Task Force
- Men Who Have Sex With Men — STI Treatment Guidelines, 2021 — Centers for Disease Control and Prevention
- Clinical Guidance for PrEP — Centers for Disease Control and Prevention
- CDC 2025 recommendation for an additional injectable PrEP option — Centers for Disease Control and Prevention
Content approved by Viva Centers