Checklist for Prescribers

Before prescribing TRUVADA for a PrEP indication, it's important that you complete the Checklist for Prescribers: Initiation of TRUVADA for Pre-exposure Prophylaxis (PrEP) with uninfected individuals and file in the individual's medical record. On each visit with an uninfected individual, complete the following steps:

  • Complete high risk evaluation of uninfected individual
  • Confirm a negative HIV-1 test immediately prior to initiating TRUVADA for a PrEP indication
    • If clinical symptoms consistent with acute viral infection are present and recent (<1 month) exposure is suspected, delay starting PrEP for at least one month and reconfirm HIV-1 status or use a test approved by the FDA as an aid in the diagnosis of HIV-1 infection, including acute or primary HIV-1 infection (Note: TRUVADA for a PrEP indication is contraindicated in individuals with unknown HIV-1 status or who are HIV-1 positive)
  • Discuss known safety risks with use of TRUVADA for a PrEP indication
  • Counsel on the importance of scheduled follow-up every 2 to 3 months including regular HIV-1 screening tests (at least every 3 months) while taking TRUVADA for PrEP to reconfirm HIV-1 status
  • Discuss the importance of discontinuing TRUVADA for a PrEP indication if seroconversion has occurred, to reduce the development of resistant HIV-1 variants
  • Counsel on the importance of adherence to daily dosing schedule
  • Counsel that TRUVADA for a PrEP indication should be used only as part of a comprehensive prevention strategy
  • Educate on practicing safer sex consistently and using condoms correctly
  • Discuss the importance of the individual knowing their HIV-1 status and, if possible, that of their partner(s)
  • Discuss the importance of and perform screening for sexually transmitted infections (STIs), such as syphilis and gonorrhea, that can facilitate HIV-1 transmission
  • Perform HBV screening test. Offer HBV vaccination as appropriate
  • Confirm estimated creatinine clearance (CrCl) ≥ 60 mL/min prior to initiation and periodically during treatment. In patients at risk for renal dysfunction, assess estimated creatinine clearance, serum phosphorus, urine glucose and urine protein before initiation of TRUVADA and periodically while TRUVADA is being used. If a decrease in estimated CrCl is observed in uninfected individuals while using TRUVADA for PrEP, evaluate potential causes and re-assess potential risks and benefits of continued use
  • Confirm that the uninfected individual at high risk is not taking other HIV-1 medications or hepatitis B medications
  • Provide education on where information about TRUVADA for a PrEP indication can be accessed
  • Discuss potential adverse events
  • Review the TRUVADA Medication Guide with the uninfected individual at high risk
  • Evaluate risk/benefit for women who may be pregnant or may want to become pregnant

The information on this site is intended for adult residents
of the United States.

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