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HIV — SCE Infectious Diseases MCQ

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ModerateHIV MedicineHIVSCE Infectious Diseases

A 29-year-old man attends the sexual health clinic requesting HIV pre-exposure prophylaxis (PrEP). He is a cisgender man who has sex with men and reports condomless anal intercourse with multiple partners. HIV test is negative. HBsAg negative. eGFR is 95 mL/min/1.73 m². He wants immediate protection as he has a sexual encounter planned tonight. What is the most appropriate PrEP initiation strategy?

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Correct answer: D — Tenofovir Disoproxil/Emtricitabine double loading dose now then one tablet daily

BASHH/BHIVA 2025 PrEP guidelines now recommend a quick-start double-dose loading option for all PrEP users. Taking a double dose of Tenofovir DF/Emtricitabine provides protective levels within approximately 2 hours for cisgender men for receptive and insertive anal sex. Option B describes the older event-based (IPERGAY) dosing regimen, which remains an alternative but the question asks about immediate protection with daily PrEP initiation. CAB-LA requires an oral lead-in period and is currently only approved in the UK for those unable to take oral PrEP.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/infections