Men who have sex with men	Trans and gender diverse people	Heterosexuals	People who inject drugs
When to offer PrEP	If the risk of acquiring HIV infection is rated as high according to the eligibility criteria discussed (see: Behavioural eligibility for PrEP below)
When to consider PrEP	If the risk of acquiring HIV infection is rated as medium according to the eligibility criteria discussed (see: Behavioural eligibility for PrEP below)
PrEP for those not meeting eligibility criteria	In all four scenarios, the individual may not necessarily meet the high- or medium-risk criteria. However, the clinician may deem, after taking a detailed history, that the individual is at high or medium risk, and may recommend or consider PrEP accordingly Note that individuals who inject drugs may have high or medium risk of HIV acquisition through sexual exposure
Clinical eligibility	Documented negative HIV test result using 4th-generation Ag/Ab test within 7 days of starting PrEP No signs or symptoms of acute HIV infection Normal renal function (eGFR >60 mL/min/1.73 m2) No contraindicated medications (those that reduce renal function or compete for active tubular secretion may increase serum concentrations of tenofovir and emtricitabine: see Patients with chronic renal failure below)
Prescribe	Daily, continuing, oral dose of coformulated tenofovir and emtricitabine ≤90-day supply Patients need to take a daily dose of PrEP for 7 days before high levels of protection are achieved for both vaginal and rectal exposure to HIV
Other services	At baseline, document hepatitis B and C infection and vaccinate for hepatitis B for those not immune (see Monitoring HBV and HCV infections below) Follow-up visits at month 1 after PrEP initiation (optional) and at least every 3 months after initiation to provide: •HIV testing using 4th-generation Ag/Ab test (at every follow-up visit), assessment for primary HIV infection if suspected (see Testing for HIV below) •Medication-adherence assessment and support (at every follow-up visit) •Discussion about the reduction of risk of HIV and sexually transmitted infections (STIs) (at every follow-up visit) •Side effects (at every follow-up visit) •STI symptom assessment at every visit and management as required •Complete HBV vaccination if commenced or chronic hepatitis B monitoring and management, as required •Assessment of renal function at 3 months and every 6 months thereafter, or more frequently as indicated •Assessment of hepatitis C status (at least every 12 months or more frequently if necessary)
Additional testing	Men who have sex with men Every 3 months, STI testing as per Australian STI testing guidelines [1]	Trans and gender diverse people Every 3 months, STI testing as per Australian STI testing guidelines [1]	Heterosexuals Assess pregnancy intent and conduct pregnancy test every 3 months if appropriate	People who inject drugs Test for STI if indicated and hepatitis C Access to clean needles/syringes and drug treatment services
Optional testing	HIV testing at 1 month or sooner at clinician's discretion based upon clinician's concerns around adherence, or that a high-risk HIV exposure occurred 3 or more days prior to PrEP initiation Bone mineral density in patients at risk on initial or subsequent assessment Vitamin D levels Proviral DNA testing if early (primary) HIV infection is suspected