Fast Five Quiz: HIV Pre-exposure Prophylaxis: Selecting Appropriate Candidates

Jason F. Okulicz, MD


January 20, 2021

The treatment as prevention (TasP) strategy has been definitively shown to prevent sexual transmission of HIV when the viral load is consistently suppressed to < 200 copies/mL, a concept referred to as "undetectable = untransmittable." The US Department of Health and Human Services (DHHS) guideline panel recommends that persons with HIV who are starting ART use another form of prevention with sexual partners for at least the first 6 months of treatment and until a viral load of < 200 copies/mL has been documented. For an HIV-negative individual, TasP can be an alternative to PrEP. However, individuals who have multiple partners, including those with unknown HIV status and/or those who are HIV-positive without consistent viral suppression, may benefit from PrEP, because TasP does not apply to those relationships.

The CD4 count does not determine HIV transmissibility, because TasP requires documentation of consistently suppressed viral load.

For more information, refer to the 2019 DHHS Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV.

Learn more about parameters for initiating HIV PrEP.


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