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Nichole Klatt, PhD

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Nichole Klatt, PhD

University of Minnesota

Professor, Division Chief
Division of Surgical Outcomes and Precision Medicine Research
University of Minnesota
Minneapolis, Minnesota

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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