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HIV preventive care vaccination — USMLE Step 3 MCQ

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HardAmbulatory Medicine / Primary CareHIV preventive care vaccinationUSMLE Step 3

A 38-year-old woman with HIV is seen for follow-up. She takes bictegravir-emtricitabine-tenofovir alafenamide and has an undetectable viral load. CD4 count is 540/mm3. She received one pneumococcal conjugate vaccine dose 2 years ago and has no record of pneumococcal polysaccharide vaccine. Which of the following is the most appropriate at this time?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Give indicated pneumococcal vaccination according to adult risk schedule

Adults with HIV require risk-based pneumococcal vaccination even with viral suppression. Inactivated vaccines are safe; live attenuated influenza vaccine is avoided in immunocompromised patients.

Reference: CDC Adult Immunization Schedule 2025; DHHS HIV Primary Care Guidance