Post Exposure Prophylaxis (PEP) HIV

HPI:[text size="3"] yo 
[select name="variable_1" value="MALE|FEMALE"] presents for post-exposure prophylaxis for HIV. RAPID HIV testing today 
[text name="variable_1" default=" REACTIVE?"]. Patient exposure on 
[date name="variable_4" default="date"] at [text name="variable_2" default="time"] (within 72 hours of treatment). 
-Related activities or events that occurred at or right before symptoms started: [text size="80"].

Source patient HIV status:
Source patient is known to be HIV-positive and exposure thru[radio name="variable_5" value="receptive and insertive anal intercourse|receptive and insertive vaginal intercourse|needle sharing|injury with exposure to blood"]
Is sex partner on ACT?
Do you know viral loads?

Unknown HIV status of source patient [radio name="variable_5" value="receptive and insertive anal intercourse|receptive and insertive vaginal intercourse|needle sharing|oral intercourse|injury with exposure to blood"]

Are you using contraception? [textarea name="variable_1" default="sample text"]
Pre-existing kidney or liver disease? [textarea name="variable_2" default="sample text"]


Discussed risk of transmission from exposure based on what is known about source patient and type of exposure, and reassured exposed patient when risk of transmission is low. Discussed risk and benefits of PEP. Advised patient of need to begin PEP within 72 hours of exposure and continue PEP for full 28-day course. Reviewed possible side effects from PEP, including fatigue, nausea, diarrhea, rash, reviewed possible toxicities, including liver and kidney dysfunction. Counseled patient on how to prevent transmission to others, using condoms to prevent sexual transmission, avoiding breastfeeding for 3 months, avoid sharing needles. Counselled that there is no transmission risk with routine household activities (such as sharing food, dishes, personal space). Educated patients about symptoms of acute HIV, including fever, sore throat, rash, fatigue, and diarrhea. Advised patient to seek medical evaluation if side effects or symptoms of acute HIV. 

Provided risk reduction counseling to prevent future exposures. Recommended additional testing at outside facility for Hepatitis C  and consider Hepatitis A/B vaccinationsand or vaccines Education regarding risk
HPI: yo
presents for post-exposure prophylaxis for HIV. RAPID HIV testing today
. Patient exposure on
at (within 72 hours of treatment).
-Related activities or events that occurred at or right before symptoms started: .

Source patient HIV status:
Source patient is known to be HIV-positive and exposure thru
Is sex partner on ACT?
Do you know viral loads?

Unknown HIV status of source patient

Are you using contraception?
Pre-existing kidney or liver disease?


Discussed risk of transmission from exposure based on what is known about source patient and type of exposure, and reassured exposed patient when risk of transmission is low. Discussed risk and benefits of PEP. Advised patient of need to begin PEP within 72 hours of exposure and continue PEP for full 28-day course. Reviewed possible side effects from PEP, including fatigue, nausea, diarrhea, rash, reviewed possible toxicities, including liver and kidney dysfunction. Counseled patient on how to prevent transmission to others, using condoms to prevent sexual transmission, avoiding breastfeeding for 3 months, avoid sharing needles. Counselled that there is no transmission risk with routine household activities (such as sharing food, dishes, personal space). Educated patients about symptoms of acute HIV, including fever, sore throat, rash, fatigue, and diarrhea. Advised patient to seek medical evaluation if side effects or symptoms of acute HIV.

Provided risk reduction counseling to prevent future exposures. Recommended additional testing at outside facility for Hepatitis C and consider Hepatitis A/B vaccinationsand or vaccines Education regarding risk

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.4, 10 form elements, 239 boilerplate words, 4 text boxes, 2 text areas, 1 dates, 2 radio buttons, 1 drop downs, 10 total clicks
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