Case Study

A 28-year-old woman presents to a community health clinic for sexually transmitted infection (STI) testing. She reports no chronic illnesses, illicit substance use, or symptoms at this time. She has a history of gonorrhea, which was appropriately treated more than one year ago. She also received one dose of injectable cabotegravir at that time but discontinued use due to discomfort with injections. She reports having multiple new male sex partners since her last STI check and engaging in oral, vaginal, and anal intercourse with condom use in three-fourths of all encounters. After further discussion, the patient says she has been engaging in transactional sex and does not know her partners’ sexual histories. She requests HIV screening and preexposure prophylaxis (PrEP).

Case Study Questions

1. Which one of the following best describes the U.S. Preventive Services Task Force (USPSTF) recommendation on PrEP to prevent acquisition of HIV?

• A. The USPSTF recommends that clinicians selectively offer PrEP using effective antiretroviral therapy to people who are at increased risk of HIV acquisition.

• B. The USPSTF recommends that clinicians prescribe PrEP using effective antiretroviral therapy to people who are at increased risk of HIV acquisition to decrease the risk of acquiring HIV.

• C. The USPSTF recommends against prescribing PrEP to older adults because they are not at increased risk of HIV acquisition.

• D. The USPSTF concludes that the evidence is insufficient to assess the balance of benefits and harms of prescribing PrEP to decrease the risk of acquiring HIV.

• E. The USPSTF recommends against prescribing PrEP to decrease the risk of acquiring HIV because the harms outweigh the benefits.