Laboratory Testing of a Cohort of Commercially Insured Users of HIV Preexposure Prophylaxis in the United States, 2011–2015

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Abstract
To ensure the health and safety of persons taking antiretroviral medication for HIV preexposure prophylaxis (PrEP), CDC guidelines recommend initial and follow-up laboratory testing. We assessed the rates of recommended testing using a commercial insurance claims database. Before taking PrEP, 45% of users were tested for HIV, 31% for creatinine, 55% for syphilis, 43% for chlamydia/gonorrhea, and 38% for hepatitis B. By 6 months after PrEP initiation, 38% were tested for HIV, 37% for creatinine, 49% for syphilis, and 39% for chlamydia/gonorrhea. Although laboratory testing was less frequent than recommended, testing rates increased over the study period.