What screening tests are necessary before starting PrEP?

Before starting PrEP, a complete medical workup is required for safety reasons:

• HIV screening test: It is imperative to confirm that you are HIV-negative before starting PrEP. A 4th generation blood test is preferred for its reliability. (Self-tests or rapid tests are generally not sufficient in this context).

• General blood work: This includes a kidney function test (creatinine measurement) because, depending on the PrEP option chosen, one of the medications can slightly affect the kidneys. It is recommended to verify that your kidneys are functioning well before and during treatment.

• Hepatitis screening: A hepatitis B serology test is often done, as the PrEP treatment (containing tenofovir) acts on this virus. If you have hepatitis B, PrEP must be managed with caution. A hepatitis C test and updating your vaccines may also be suggested.

• Other STI screening: A complete screening for sexually transmitted infections is usually offered at the same time (e.g., syphilis via blood test, and gonorrhea/chlamydia via urine and/or throat/anal swabs, depending on your practices).

• Other tests: For female patients, a pregnancy test may be performed. The healthcare professional may adapt the workup to your personal situation.

In summary, this initial workup aims to ensure you do not already have HIV, that you have no medical contraindications, and to treat or vaccinate if needed for other infections. While this may seem like many tests, they are generally grouped into a single blood draw and a few swabs, usually done in one visit.