HIV prevention — CCFP MCQ

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ModeratePreventive care and screeningHIV preventionCCFP

A 32-year-old man who has sex with men reports condomless sex with multiple partners. His HIV test is negative today, creatinine is normal, and hepatitis B serology confirms immunity. He asks about HIV prevention. What would you advise?

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Correct answer: B — Discuss HIV pre-exposure prophylaxis with regular HIV, STI, and renal monitoring

This patient meets clear indications for PrEP: HIV-negative MSM with ongoing high-risk condomless exposures and multiple partners. The 2025 Canadian guideline recommends offering PrEP to those who request it after risk assessment. Hepatitis B immunity is not a contraindication; it is reassuring. Option D mischaracterizes PEP (which is acute, within 72 hours, not chronic prevention). Option A is false—HBV immunity does not preclude PrEP. Option E has no evidence base. Option C is dangerously inadequate given the ongoing risk and diagnostic window period. Option B correctly recommends PrEP with the essential monitoring: regular HIV testing (to detect acquisition), STI screening (MSM at high risk for co-infections), and renal function (TDF/FTC requires baseline and periodic monitoring despite normal creatinine today).

Reference: Canadian guideline on HIV pre- and postexposure prophylaxis: 2025 update. CMAJ. November 30, 2025. https://www.cmaj.ca/content/197/41/E1374