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Primary Care Guidance for Persons With HIV - 2021

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7 38. Following hysterectomy for benign disease, routine screening for vaginal cancer is NOT recommended for persons with HIV. Those with a history of high-grade CIN adenocarcinoma in situ or invasive cervical cancer should be followed with annual vaginal cuff Pap tests. Anal Cancer Screening 39. Persons with a history of receptive anal intercourse, abnormal cervical Pap test results, and all persons with genital warts should have an anal Pap test if access to appropriate referral for follow-up, including high-resolution anoscopy, is available. Glucose-6-Phosphate Dehydrogenase 40. Screening for glucose-6-phosphate dehydrogenase (G6PD) deficiency is recommended before starting therapy with oxidant drugs such as dapsone, primaquine, or sulfonamides in patients with a predisposing racial or ethnic background. Pregnancy Testing 41. All persons of childbearing potential should have a pregnancy test upon initiation of care or reengagement in care. Serum Testosterone Level 42. Morning serum testosterone levels are recommended in adult cisgender men with decreased libido, erectile dysfunction, reduced bone mass or low trauma fractures, hot flashes, or sweats. 43. Obtaining testosterone levels in women at baseline in non-research settings is NOT recommended. Tests NOT Recommended for General Screening Purposes 44. Routine testing for HSV IgG, CMV IgG, Toxoplasma IgG, and biomarkers of inflammation is NOT recommended. 45. Testing for serum cryptococcal antigen may be considered in persons with CD4 <100 cells/mm 3 or in symptomatic patients.

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