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Primary Care Guidance for Persons With HIV - 2021

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9 Screening and Vaccination for Infectious Diseases Screening for Chlamydia, Gonorrhea, Trichomoniasis 50. Screening for syphilis, chlamydia, and gonorrhea in asymptomatic persons should be repeated at least annually after initial screening, or every 3–6 months depending on sexual activities, presence of other STIs in the patient or their partner, and local community STI prevalence. 51. All persons having vaginal sex should be screened for trichomoniasis annually. 52. Tailored messages are critical for patients who report persistent high-risk behavior or who have symptoms or signs of STIs. In nearly all situations, the provider should offer brief counseling. In general, persons exhibiting ongoing risk behavior should also be referred to programs capable of offering more extensive intervention programs. Screening and Vaccination for Other Infectious Diseases 53. Perform tuberculosis screening annually in persons at risk for infection. (See Section II) 54. Repeat testing is recommended in patients with advanced HIV disease who initially had negative TST or IGRA results but subsequently experienced an increase in the CD4 cell count to >200 cells/µL on ART and who may thus have developed sufficient immunocompetence to mount a positive reaction. 55. Vaccinations for pneumococcal infection, influenza, tetanus- diphtheria-whooping cough, and meningococcus should be offered according to CDC Opportunistic Infection and ACIP guidelines. 56. Asymptomatic persons with CD4 >200 cells/mm 3 who are traveling internationally should receive required vaccinations including live vaccines.

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