Checklist for Prescribers

Before prescribing emtricitabine/tenofovir disoproxil fumarate for HIV-1 PrEP, it's important that you complete the Checklist for Prescribers: Initiation of Emtricitabine/Tenofovir Disoproxil Fumarate for HIV-1 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 risk evaluation of uninfected individual
  • Confirm a negative HIV-1 test immediately prior to initiating emtricitabine/tenofovir disoproxil fumarate for HIV-1 PrEP.
    • If clinical symptoms consistent with acute viral infection are present and recent (<1 month) exposure is suspected, delay starting HIV-1 PrEP for at least one month and reconfirm HIV-1 status or use a test approved or cleared by the FDA as an aid in the diagnosis of HIV-1 infection, including acute or primary HIV-1 infection (Note: emtricitabine/tenofovir disoproxil fumarate for HIV-1 PrEP is contraindicated in individuals with unknown HIV-1 status or who are HIV-1 positive)
  • Discuss known safety risks with use of emtricitabine/tenofovir disoproxil fumarate for HIV-1 PrEP
  • 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 emtricitabine/tenofovir disoproxil fumarate for HIV-1 PrEP to reconfirm HIV-1 status.
    • Some individuals, such as adolescents, may benefit from more frequent visits and counseling
  • Discuss the importance of discontinuing emtricitabine/tenofovir disoproxil fumarate for HIV-1 PrEP 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 emtricitabine/tenofovir disoproxil fumarate for HIV-1 PrEP 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 virologic suppression in partner(s) with HIV
  • Discuss the importance of and perform screening for sexually transmitted infections (STIs), such as syphilis, chlamydia and gonorrhea, that can facilitate HIV-1 transmission
  • Perform HBV screening test. Offer HBV vaccination as appropriate
  • On a clinically appropriate schedule, assess serum creatinine, estimated creatinine clearance, urine glucose, and urine protein in all patients before initiation of emtricitabine/tenofovir disoproxil fumarate and periodically while emtricitabine/tenofovir disoproxil fumarate is being used. In patients with chronic kidney disease, also assess serum phosphorus. If a decrease in estimated CrCl is observed in uninfected individuals while using emtricitabine/tenofovir disoproxil fumarate for HIV-1 PrEP, evaluate potential causes and re-assess potential risks and benefits of continued use
  • Confirm that the uninfected individual at risk is not taking other HIV-1 medications or hepatitis B medications
  • Provide education on where information about emtricitabine/tenofovir disoproxil fumarate for HIV-1 PrEP can be accessed
  • Discuss potential adverse events
  • Review the emtricitabine/tenofovir disoproxil fumarate Medication Guide with the uninfected individual at risk
  • Evaluate risk/benefit for women who may be pregnant or may want to become pregnant

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

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