HIV PrEP: biology + behaviour + chemistry

Send us Fan MailIn this episode, we dive into the essential updates from the ASHM 2025 National PrEP Guidelines, providing a comprehensive clinical management and prescribing summary tailored for GPs and Nurse Practitioners.Join us as we break down exactly how Pre-Exposure Prophylaxis (PrEP) works, utilizing co-formulated tenofovir disoproxil and emtricitabine (TD/FTC) to safely block HIV replication before an infection can establish. Whether you are looking to refresh your day-to-day clinical prescribing knowledge or hunting for high-yield exam pearls for the AKT or KFP, this episode covers all the practical steps you need to know.Key topics covered in this episode:Patient Suitability & Clinical Assessment: Discover who is most at risk and the critical pre-screening steps required before prescribing. We cover why you must always use a 4th-generation venous HIV Ag/Ab test, the importance of excluding acute HIV, and how to properly check renal function (eGFR).Daily vs. On-Demand (2-1-1) Dosing: We explore the critical differences between continuous daily PrEP and the off-label, event-driven "2-1-1" method. You will learn the strict eligibility criteria for on-demand use and the necessary timelines to achieve protective drug levels.Contraindications & Specialist Referrals: Learn when PrEP is absolutely contraindicated (such as untreated acute HIV or an eGFR < 30) and the specific scenarios where a patient should be promptly referred to a specialist or an s100 HIV prescriber.Patient Counselling & Ongoing Monitoring: Get practical tips on communicating the importance of adherence, managing "start-up syndrome" side effects, conducting mandatory quarterly STI and HIV testing, and the specific rules for safely stopping PrEP based on the patient's biological sex and hormone use.Tune in to ensure your HIV prevention and prescribing practices are up-to-date, safe, and highly effective for your patients!Support the show⚠️ Disclaimer: The voices in this podcast are AI-generated. This content is produced for entertainment and learning purposes only and does not constitute medical advice. Clinical decisions should always be made in accordance with current guidelines, individual patient circumstances, and in consultation with appropriate colleagues and specialists.