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Marina Klein, MD, MS

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Marina Klein

Marina Klein, MD, MS

McGill University

Core Faculty

Professor of Medicine
McGill University
Montreal, Canada

131 Steuart St, Suite 500, San Francisco, CA 94105

Phone: (415) 544-9400 | info@iasusa.org

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Practice Question of the Week

November 29, 2021: When to Start and Continue PrEP

Your patient has been taking daily preexposure prophylaxis (PrEP) for more than 2 years and reports excellent adherence while on PrEP, but he missed the last quarterly visit. He returns to clinic several weeks later and reports that he stopped PrEP approximately 3 months ago after his insurance lapsed, and he now wants to restart PrEP. His last condomless anal sex was approximately 2 weeks ago with a regular partner who is HIV negative. He reports that he had a bad cold last week with chills, subjective fevers, a sore throat, and a nonproductive cough. All of his roommates have also been sick with similar symptoms. His rapid HIV antibody (Ab)/antigen (Ag) test is negative. What is the most appropriate next step?
- A. Start postexposure prophylaxis (PEP)
- B. Check HIV viral load and start PrEP today
- C. Check HIV viral load and delay starting PrEP
- D. Start 3-drug antiretroviral treatment twice daily

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