Haukoos et al reported a simple algorithm for identifying a patient in the Emergency Department who may benefit from HIV pre-exposure prophylaxis (PrEP). The authors are from the University of Colorado, Denver Health Medical Center, and Highland Hospital.
Patient selection: HIV-negative patient in Emergency Department
Parameters:
(1) Denver HIV Risk Score (DHRS), from -4 to 73 (very low risk < 20; very high risk >= 50)
(2) shared equipment for injection drug use in the past 6 months
(3) had bacterial STI/STD in the past 6 months
(4) had condomless sex with partner who injects drugs in the past 6 months
(5) had condomless sex with a gay or bisexual male in the past 6 months
(6) had condomless sex with HIV AND detectable viral load in the past 6 months
Criteria for PrEP - both of the following:
(1) DHRS >= 25
(2) one or more of items 2 to 6 true
If DHRS < 25 or if none of the following items are true, then PrEP is not appropriate.
