Preventive Measures

  • Safe-sex practices including using condoms and/or dental dams
  • Pre-exposure prophylaxis (PrEP) treatment has been approved by the FDA
    • Consists of tenofovir (TDF) and emtricitabine (FTC)
    • Needs to be taken on a regular daily schedule
  • Post-exposure prophylaxis (PEP) is available for those who have experienced an exposure to HIV-infected fluids, such as needle sticks or unprotected sex with an HIV-positive individual.
    • Needs to be initiated within 72 hours of the exposure and is taken for 4 weeks
      • For children older than age 13 years and adults, the preferred regimen is tenofovir AND emtricitabine WITH raltegravir OR dolutegravir
      • For those with renal dysfunction, the preferred regimen is adjusted renal dosages of zidovudine AND lamivudine WITH raltegravir OR dolutegravir
      • For women of childbearing age who are sexually active or have been sexually assaulted and not using birth control OR for pregnant women, the recommended regimen is raltegravir, tenofovir, and emtricitabine
      • For children aged 2 to 12 years, the preferred regimen is age- and weight-adjusted dosages of tenofovir AND emtricitabine AND raltegravir

Screening


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  • The CDC and USPSTF recommend screening of all individuals between the ages of 15 and 65 years.  Screening is also recommended for those younger than age 15 years or older than age 65 years who may be at increased risk.  Also recommended is routine screening of all pregnant individuals.
  • The CDC recommends that patients at high risk should be screened at least annually.
  • Screening should be done routinely unless the patient declines the test (opt-out screening)

Vaccination

  • There are no current vaccines available for HIV.

Related Articles

Alyssa Abebe, MPAS, PA-C, is associate program director and assistant professor, and Judy Truscott, MPAS, PA-C, is program director and assistant professor in the Physician Assistant program at Chatham University, Pittsburgh, Pennsylvania.

Resources

  1. Chu C, Selwyn PA. Diagnosis and initial management of acute HIV infection.  Am Fam Physician. 2010;81(10):1239-1244.
  2. Final Recommendation Statement: Human Immunodeficiency Virus (HIV) Infection: Screening. U.S. Preventive Services Task Force website. http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/human-immunodeficiency-virus-hiv-infection-screening. May 2015. Accessed January 16, 2019.
  3. Guidelines for the use of antiviral agents in adults and adolescents living with HIV. AIDSinfo website. https://aidsinfo.nih.gov/guidelines/brief-html/1/adult-and-adolescent-arv/0. Accessed January 16, 2019.
  4. HIV testing. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/hiv/basics/testing.html. Accessed January 16, 2019.
  5. HIV treatment. AIDSinfo. Available at: https://aidsinfo.nih.gov/education-materials/fact-sheets/21/51/hiv-treatment–the-basics. Accessed January 16, 2019.
  6. Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV—United States, 2016. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/hiv/pdf/programresources/cdc-hiv-npep-guidelines.pdf. Accessed January 16, 2019.