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CDC testing schedules by PrEP regimen
The table summarizes current U.S. CDC guidance. Daily oral PrEP includes F/TDF or F/TAF; injectable options include cabotegravir (CAB) and lenacapavir (LEN). HIV tests and STI screening follow separate schedules.
| PrEP regimen | HIV testing | STI screening |
|---|---|---|
| Daily oral F/TDF or F/TAF | At least every 3 months: repeat HIV antigen/antibody and HIV-1 RNA tests and assess for symptoms of acute HIV. Refills are limited to no more than 90 days until the next HIV test. | At least every 6 months, screen sexually active people for syphilis and gonorrhea, and gay and bisexual men for chlamydia, even without symptoms. At least every 12 months, screen heterosexually active people for chlamydia, even without symptoms. Screen sooner if symptoms arise; CDC also recommends more frequent screening for some asymptomatic gay and bisexual men with risk factors for recurrent bacterial STIs. |
| Injectable cabotegravir (CAB) | Test at the one-month visit after the initial injection, then at least every 2 months beginning in month 3. Use HIV antigen/antibody and HIV-1 RNA tests and assess for symptoms. | For gay and bisexual men, screen for bacterial STIs at least every 4 months beginning in month 3. For heterosexually active people, screen at least every 6 months beginning in month 7, and screen for chlamydia annually beginning in month 13. |
| Injectable lenacapavir (LEN) | Use a blood-based HIV antigen/antibody test at initiation and at follow-up injections, which occur every 6 months. At initiation, obtain an HIV RNA test if available, but do not delay the first injection while waiting for that result. If RNA testing is unavailable, schedule a repeat laboratory antigen/antibody test in 4 weeks to rule out an undetected infection at baseline. | Screen for STIs at follow-up, using the relevant body sites, and plan additional screening according to individual risk. Screening may be more frequent than the six-month injection visits. |
These intervals and recommendations come from the CDC Clinical Guidance for PrEP and, for lenacapavir, the CDC’s 2025 clinical recommendation. The CDC PrEP guidance page is dated April 30, 2026; the lenacapavir recommendation was published September 18, 2025. Recommendations may differ outside the United States.
Why HIV tests and STI screens do not share one interval
HIV testing is part of deciding whether it is safe to start or continue a particular PrEP regimen. STI screening looks for infections such as syphilis, gonorrhea, and chlamydia, and its timing depends on the regimen and a person’s risk. A six-month injection visit therefore does not necessarily mean STI screening only happens every six months: CDC says screening for people taking lenacapavir may be more frequent than injection visits.
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Which tests and sample sites may be used
The appropriate tests and specimens depend on symptoms, exposures, and clinician assessment. CDC guidance lists blood, urine, vaginal, oral, and rectal specimens as appropriate in different circumstances. Tell the clinician which kinds of sex and body sites are relevant so screening can be selected accordingly; a urine test alone, for example, may not address an exposure at another site.
When to seek testing or advice before the routine visit
- STI symptoms: CDC recommends testing sexually active people with signs or symptoms of an STI rather than waiting for the next scheduled screen.
- Possible recent HIV exposure or symptoms that could indicate acute HIV: contact a clinician promptly instead of waiting for the routine PrEP test. For someone taking lenacapavir, CDC advises assessing for acute HIV symptoms at follow-up and using HIV RNA testing when acute infection is suspected.
- Unclear follow-up HIV result: CDC advises repeating laboratory testing on a new blood specimen after 5–7 days, using both an HIV antigen/antibody test and an HIV-1 RNA assay.
PrEP is highly effective at preventing HIV when taken as prescribed, but it does not remove the need for recommended monitoring or STI screening.
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Can an at-home oral-swab HIV test replace PrEP monitoring?
Usually not. CDC says oral-swab HIV self-testing is generally not recommended for people taking PrEP because it may miss a recent infection in someone using PrEP medicines. If clinic or laboratory visits are impossible, CDC mentions self-testing as an exceptional option, but prefers laboratory HIV testing when feasible. A retail self-test should not be treated as a substitute for the scheduled clinical tests above.
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