GP Vivas · sexual-health-and-gender-diversity
HIV testing, PrEP, and PEP — structured viva
Structured oral on HIV prevention in general practice: window periods and RNA testing, indicator-condition testing, the PROUD/IPERGAY/iPrEx PrEP evidence, monitoring and renal/bone safety, the PEP clock, and defending U=U with trial data.
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Target exams
RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'HIV medicine belongs in hospitals, not general practice.' The viva branches through testing strategy, seroconversion recognition, PrEP evidence and dosing, monitoring and safety, PEP delivery, and U=U counselling.
Stem
A registrar argues that HIV is too specialised for routine GP care. The examiner asks you to respond with evidence. [1]
References10ShowHide
- [1]McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet, 2016.PMID 26364263
- [2]Molina JM, Capitant C, Spire B, Pialoux G, Cotte L, et al. On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection. N Engl J Med, 2015.PMID 26624850
- [3]Antoni G, Tremblay C, Delaugerre C, Charreau I, Cua E, et al. On-demand pre-exposure prophylaxis with tenofovir disoproxil fumarate plus emtricitabine among men who have sex with men with less frequent sexual intercourse: a post-hoc analysis of the ANRS IPERGAY trial. Lancet HIV, 2020.PMID 31784343
- [4]Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med, 2010.PMID 21091279
- [5]Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet, 2019.PMID 31056293
- [6]Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, et al. Antiretroviral Therapy for the Prevention of HIV-1 Transmission. N Engl J Med, 2016.PMID 27424812
- [7]Tanner MR, O'Shea JG, Byrd KM, Johnston M, Dumitru GG, et al. Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV - CDC Recommendations, United States, 2025. MMWR Recomm Rep, 2025.PMID 40331832
- [8]Adhikari EH, Macias D, Gaffney D, White S, Rogers VL, et al. Diagnostic accuracy of fourth-generation ARCHITECT HIV Ag/Ab Combo assay and utility of signal-to-cutoff ratio to predict false-positive HIV tests in pregnancy. Am J Obstet Gynecol, 2018.PMID 29913173
- [9]Chu C, Selwyn PA Diagnosis and initial management of acute HIV infection. Am Fam Physician, 2010.PMID 20507048
- [11]Mulligan K, Glidden DV, Anderson PL, Liu A, McMahan V, et al. Effects of Emtricitabine/Tenofovir on Bone Mineral Density in HIV-Negative Persons in a Randomized, Double-Blind, Placebo-Controlled Trial. Clin Infect Dis, 2015.PMID 25908682