There is no single testing interval for everyone taking PrEP. Under current U.S. CDC guidance, HIV testing is generally every three months with daily oral PrEP, at the first-month visit and then at least every two months with cabotegravir injections, and at initiation and six-month follow-up injections with lenacapavir. STI screening follows a separate schedule based on the medication, symptoms, exposure sites, and individual risk.
How often should you get HIV and STI tests on PrEP?
The schedules below summarize U.S. Centers for Disease Control and Prevention (CDC) recommendations. HIV monitoring helps determine whether it is safe to continue or start a PrEP medication; STI screening looks for infections such as syphilis, gonorrhea, and chlamydia. The intervals are not interchangeable. See the CDC’s Clinical Guidance for PrEP and its 2025 clinical recommendation for injectable lenacapavir.
| PrEP regimen | HIV testing | STI screening |
|---|---|---|
| Daily oral F/TDF or F/TAF | At least every 3 months: HIV antigen/antibody and HIV-1 RNA tests, plus assessment for symptoms of acute HIV. PrEP 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. Heterosexually active people should be screened for chlamydia at least annually, even without symptoms. Some gay and bisexual men with risk factors for recurrent bacterial STIs may need more frequent screening. |
| Injectable cabotegravir (CAB) | Test at the month-1 visit after the initial injection, then at least every 2 months beginning in month 3. CDC specifies HIV antigen/antibody and HIV-1 RNA tests, along with symptom assessment. | For gay and bisexual men, CDC recommends bacterial STI screening 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 every 6 months. At initiation, obtain an HIV RNA test if available, but do not delay the first injection for its result. If RNA testing is unavailable, schedule a repeat laboratory antigen/antibody test in 4 weeks to check for an infection missed at baseline. | Screen for STIs at follow-up, using the appropriate sites. Arrange additional screening according to individual risk; it may be needed more often than the six-month injection visits. |
These are CDC schedules, not an individualized plan. Your clinician may recommend different timing based on symptoms, exposures, and other factors. Depending on the infection and exposure, samples may include blood, urine, or vaginal, oral, or rectal specimens.
Why HIV and STI testing follow different schedules
HIV testing is linked to the PrEP regimen and its safe continuation. STI screening has its own timing and may require samples from more than one exposed site. In particular, the CDC lenacapavir recommendation says to plan follow-up STI screening based on risk, which may mean screening more often than injections.
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An oral-swab HIV self-test is usually not recommended for routine PrEP monitoring because it may miss a recent infection in someone taking PrEP medicines. If a clinic or laboratory visit is impossible, CDC describes self-testing as an exceptional option; laboratory testing remains preferred when feasible. A retail self-test does not replace the scheduled clinical monitoring above.
When to seek testing or advice before your next routine visit
- STI symptoms: CDC recommends testing sexually active people who have signs or symptoms of an STI. Contact a clinician rather than waiting for the next scheduled screen.
- Possible recent HIV exposure or symptoms of acute HIV: Seek prompt clinical advice instead of waiting for the routine PrEP test. With lenacapavir, CDC advises assessing for acute HIV symptoms at follow-up and using HIV RNA testing when acute infection is suspected.
- Unclear HIV follow-up 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.
Why follow-up still matters when PrEP is effective
PrEP prevents HIV but does not remove the need for monitoring or STI screening. CDC estimates that oral and injectable PrEP, when taken as prescribed, reduce the risk of getting HIV through sex by about 99%. That effectiveness estimate is not a testing schedule and does not mean follow-up can be skipped.
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