This tab describes the data that may be collected during the pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP) workflow (HIV.C)

Client's reason for the prevention visit

Client is visiting for the recommended 3-month pre-exposure prophylaxis (PrEP) visit

The client had suspected or known exposure to HIV

When the suspect exposure to HIV took place

The client is currently taking PrEP. Oral pre-exposure prophylaxis (PrEP) of HIV is the use of ARV drugs by people who are not infected with HIV to block the acquisition of HIV.

Way in which pre-exposure prophylaxis (PrEP) is taken (daily or event-driven)

Other PrEP dosing type (specify)

Client reports taking ED-PrEP for at risk exposures over a 3-month period

HIV pre-exposure prophylaxis (PrEP) regimen

The client's experience in taking PrEP

The date on which the client started or restarted pre-exposure prophylaxis (PrEP)

Client stopped taking pre-exposure prophylaxis (PrEP)

Date client stopped taking pre-exposure prophylaxis (PrEP)

The client's history in taking post-exposure prophylaxis (PEP) for HIV prevention

Dates when the client previously used post-exposure prophylaxis (PEP)

Date client completes PEP course

Signs the client is at a substantial risk of HIV infection

Client's intention or desire in the next year to either become pregnant or prevent a future pregnancy (in serodiscordant partnerships)

Symptoms that could suggest an acute HIV infection

Treatment adherence of client's sex partner for partners that are HIV-positive

The client is suitable for PrEP

After being evaluated as suitable for PrEP, the client was offered PrEP

Listing of tests for clients on or starting pre-exposure prophylaxis (PrEP) that may be recommended or should be considered

Test serum creatinine to identify pre-existing renal disease (estimated creatinine clearance less than 60 ml/min)

Test serum creatinine to identify pre-existing renal disease (estimated creatinine clearance less than 60 ml/min).

Date the client was dispensed medications

Date the client was prescribed medications

Medications the client was prescribed

Client was prescribed other medications (specify)

PrEP product that the client was prescribed

Client was prescribed other PrEP product (specify)

Date client was prescribed PrEP, including initial prescription and repeats

Date client was dispensed PrEP

Volume of PrEP product the client was prescribed or dispensed (for example, number of pills, number of devices)

Date the client was prescribed PEP

Date client completes PEP course

Preferred backbone regimen for PEP

Alternative backbone regimen for PEP

Preferred third drug for PEP

Alternative third drug for PEP

Estimated creatinine clearance of the client returned from lab in mL/min

Value used for gender for calculating creatinine clearance if required. For transgender populations, the sex at birth is used in the Cockcroft-Gault equation if the person is not using hormone therapy; among transgender populations using hormone therapy for more than three months, the current gender can be used.

If the laboratory does not have the capacity to estimate creatinine clearance, the provider can use the Cockcroft–Gault equation to calculate estimated creatinine clearance based on measured serum creatinine, the client’s sex at birth, age and estimated lean body weight.

Date when the specimen was collected

Listing of contraindications to pre-exposure prophylaxis (PrEP)

Client has another allergy or contraindication to a medicine in the pre-exposure prophylaxis (PrEP) regimen (specify)

Client was prescribed pre-exposure prophylaxis (PrEP) on a first visit

Days of medication client has been prescribed

HIV pre-exposure prophylaxis (PrEP) regimen prescribed

Whether adherence counselling was provided

Date the client is to return for monitoring, re-supply, or any other reason

Type of follow-up appointment for testing services

Other reason for the follow-up appointment (specify)

Linkage made from HIV testing to enrolment in care following an HIV diagnosis

Offer or refer to prevention services

Date client was provided with condoms

Number of condoms given to the client, if any were distributed

Type of condom provided to client

Whether any HIV self-test kits were given to the client

Number of HIV self-test kits distributed to the client

Whom the client plans to give the HIV self-test kit (self, sexual partner, social contact, etc.)

Offer or refer to sexual and reproductive health services

Other clinical services offered or referrals given to the client

Offer or refer for other support services

This tab describes the data that may be collected during the pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP) workflow (HIV.C)

Client's reason for the prevention visit

Client is visiting for the recommended 3-month pre-exposure prophylaxis (PrEP) visit

The client had suspected or known exposure to HIV

When the suspect exposure to HIV took place

The client is currently taking PrEP. Oral pre-exposure prophylaxis (PrEP) of HIV is the use of ARV drugs by people who are not infected with HIV to block the acquisition of HIV.

Way in which pre-exposure prophylaxis (PrEP) is taken (daily or event-driven)

Other PrEP dosing type (specify)

Client reports taking ED-PrEP for at risk exposures over a 3-month period

HIV pre-exposure prophylaxis (PrEP) regimen

The client's experience in taking PrEP

The date on which the client started or restarted pre-exposure prophylaxis (PrEP)

Client stopped taking pre-exposure prophylaxis (PrEP)

Date client stopped taking pre-exposure prophylaxis (PrEP)

The client's history in taking post-exposure prophylaxis (PEP) for HIV prevention

Dates when the client previously used post-exposure prophylaxis (PEP)

Date client completes PEP course

Signs the client is at a substantial risk of HIV infection

Client's intention or desire in the next year to either become pregnant or prevent a future pregnancy (in serodiscordant partnerships)

Symptoms that could suggest an acute HIV infection

Treatment adherence of client's sex partner for partners that are HIV-positive

The client is suitable for PrEP

After being evaluated as suitable for PrEP, the client was offered PrEP

Listing of tests for clients on or starting pre-exposure prophylaxis (PrEP) that may be recommended or should be considered

Test serum creatinine to identify pre-existing renal disease (estimated creatinine clearance less than 60 ml/min)

Test serum creatinine to identify pre-existing renal disease (estimated creatinine clearance less than 60 ml/min).

Date the client was dispensed medications

Date the client was prescribed medications

Medications the client was prescribed

Client was prescribed other medications (specify)

PrEP product that the client was prescribed

Client was prescribed other PrEP product (specify)

Date client was prescribed PrEP, including initial prescription and repeats

Date client was dispensed PrEP

Volume of PrEP product the client was prescribed or dispensed (for example, number of pills, number of devices)

Date the client was prescribed PEP

Date client completes PEP course

Preferred backbone regimen for PEP

Alternative backbone regimen for PEP

Preferred third drug for PEP

Alternative third drug for PEP

Estimated creatinine clearance of the client returned from lab in mL/min

Value used for gender for calculating creatinine clearance if required. For transgender populations, the sex at birth is used in the Cockcroft-Gault equation if the person is not using hormone therapy; among transgender populations using hormone therapy for more than three months, the current gender can be used.

If the laboratory does not have the capacity to estimate creatinine clearance, the provider can use the Cockcroft–Gault equation to calculate estimated creatinine clearance based on measured serum creatinine, the client’s sex at birth, age and estimated lean body weight.

Date when the specimen was collected

Listing of contraindications to pre-exposure prophylaxis (PrEP)

Client has another allergy or contraindication to a medicine in the pre-exposure prophylaxis (PrEP) regimen (specify)

Client was prescribed pre-exposure prophylaxis (PrEP) on a first visit

Days of medication client has been prescribed

HIV pre-exposure prophylaxis (PrEP) regimen prescribed

Whether adherence counselling was provided

Date the client is to return for monitoring, re-supply, or any other reason

Type of follow-up appointment for testing services

Other reason for the follow-up appointment (specify)

Linkage made from HIV testing to enrolment in care following an HIV diagnosis

Offer or refer to prevention services

Date client was provided with condoms

Number of condoms given to the client, if any were distributed

Type of condom provided to client

Whether any HIV self-test kits were given to the client

Number of HIV self-test kits distributed to the client

Whom the client plans to give the HIV self-test kit (self, sexual partner, social contact, etc.)

Offer or refer to sexual and reproductive health services

Other clinical services offered or referrals given to the client

Offer or refer for other support services

This tab describes the data that may be collected during the pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP) workflow (HIV.C)

Client's reason for the prevention visit

Client is visiting for the recommended 3-month pre-exposure prophylaxis (PrEP) visit

The client had suspected or known exposure to HIV

When the suspect exposure to HIV took place

The client is currently taking PrEP. Oral pre-exposure prophylaxis (PrEP) of HIV is the use of ARV drugs by people who are not infected with HIV to block the acquisition of HIV.

Way in which pre-exposure prophylaxis (PrEP) is taken (daily or event-driven)

Other PrEP dosing type (specify)

Client reports taking ED-PrEP for at risk exposures over a 3-month period

HIV pre-exposure prophylaxis (PrEP) regimen

The client's experience in taking PrEP

The date on which the client started or restarted pre-exposure prophylaxis (PrEP)

Client stopped taking pre-exposure prophylaxis (PrEP)

Date client stopped taking pre-exposure prophylaxis (PrEP)

The client's history in taking post-exposure prophylaxis (PEP) for HIV prevention

Dates when the client previously used post-exposure prophylaxis (PEP)

Date client completes PEP course

Signs the client is at a substantial risk of HIV infection

Client's intention or desire in the next year to either become pregnant or prevent a future pregnancy (in serodiscordant partnerships)

Symptoms that could suggest an acute HIV infection

Treatment adherence of client's sex partner for partners that are HIV-positive

The client is suitable for PrEP

After being evaluated as suitable for PrEP, the client was offered PrEP

Listing of tests for clients on or starting pre-exposure prophylaxis (PrEP) that may be recommended or should be considered

Test serum creatinine to identify pre-existing renal disease (estimated creatinine clearance less than 60 ml/min)

Test serum creatinine to identify pre-existing renal disease (estimated creatinine clearance less than 60 ml/min).

Date the client was dispensed medications

Date the client was prescribed medications

Medications the client was prescribed

Client was prescribed other medications (specify)

PrEP product that the client was prescribed

Client was prescribed other PrEP product (specify)

Date client was prescribed PrEP, including initial prescription and repeats

Date client was dispensed PrEP

Volume of PrEP product the client was prescribed or dispensed (for example, number of pills, number of devices)

Date the client was prescribed PEP

Date client completes PEP course

Preferred backbone regimen for PEP

Alternative backbone regimen for PEP

Preferred third drug for PEP

Alternative third drug for PEP

Estimated creatinine clearance of the client returned from lab in mL/min

Value used for gender for calculating creatinine clearance if required. For transgender populations, the sex at birth is used in the Cockcroft-Gault equation if the person is not using hormone therapy; among transgender populations using hormone therapy for more than three months, the current gender can be used.

If the laboratory does not have the capacity to estimate creatinine clearance, the provider can use the Cockcroft–Gault equation to calculate estimated creatinine clearance based on measured serum creatinine, the client’s sex at birth, age and estimated lean body weight.

Date when the specimen was collected

Listing of contraindications to pre-exposure prophylaxis (PrEP)

Client has another allergy or contraindication to a medicine in the pre-exposure prophylaxis (PrEP) regimen (specify)

Client was prescribed pre-exposure prophylaxis (PrEP) on a first visit

Days of medication client has been prescribed

HIV pre-exposure prophylaxis (PrEP) regimen prescribed

Whether adherence counselling was provided

Date the client is to return for monitoring, re-supply, or any other reason

Type of follow-up appointment for testing services

Other reason for the follow-up appointment (specify)

Linkage made from HIV testing to enrolment in care following an HIV diagnosis

Offer or refer to prevention services

Date client was provided with condoms

Number of condoms given to the client, if any were distributed

Type of condom provided to client

Whether any HIV self-test kits were given to the client

Number of HIV self-test kits distributed to the client

Whom the client plans to give the HIV self-test kit (self, sexual partner, social contact, etc.)

Offer or refer to sexual and reproductive health services

Other clinical services offered or referrals given to the client

Offer or refer for other support services