HIV/AIDS Control Program – structure and outcomes MCQs With Answer

Introduction

The HIV/AIDS Control Program integrates surveillance, prevention, testing, antiretroviral therapy (ART), PMTCT, harm‑reduction and monitoring & evaluation to reduce incidence, morbidity and mortality. For B. Pharm students, understanding program structure, national ART regimens, procurement and supply‑chain management, pharmacovigilance, adherence counseling, viral‑load monitoring, diagnostic algorithms and outcome indicators (retention, viral suppression, MTCT rates) is essential. This concise, pharmacy‑focused overview emphasizes data‑driven decision making, integration with TB/STI services, key populations, and clinical‑pharmaceutical roles in improving patient outcomes and program effectiveness. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which component is NOT a routine part of a comprehensive national HIV/AIDS control program?

• Surveillance and data management
• Antiretroviral therapy (ART) delivery
• Universal vaccination against HIV
• Prevention of mother-to-child transmission (PMTCT)

Correct Answer: Universal vaccination against HIV

Q2. What is the current WHO‑recommended preferred first‑line adult ART backbone in many national programs?

• AZT + 3TC + EFV
• TDF + 3TC + DTG (TLD)
• ABC + ddI + NVP
• LPV/r + ZDV + FTC

Correct Answer: TDF + 3TC + DTG (TLD)

Q3. Which of the following is the primary virological indicator used to measure ART program outcomes?

• CD4 count increase
• Number of clinic visits per year
• Viral load suppression rate
• Time to seroconversion

Correct Answer: Viral load suppression rate

Q4. For routine monitoring, when is the first viral load test recommended after ART initiation in most guidelines?

• At 1 month
• At 6 months
• At 24 months
• Only when clinical symptoms appear

Correct Answer: At 6 months

Q5. According to WHO guidance, virologic failure is defined as a persistently elevated viral load above which threshold?

• 50 copies/mL
• 200 copies/mL
• 1000 copies/mL
• 5000 copies/mL

Correct Answer: 1000 copies/mL

Q6. Which PMTCT strategy involves lifelong ART for all pregnant and breastfeeding women with HIV?

• Option A
• Option B
• Option B+
• Option C

Correct Answer: Option B+

Q7. What is the recommended diagnostic test for early infant HIV diagnosis at around 6 weeks of age?

• Antibody rapid test
• p24 antigen lateral flow
• HIV DNA PCR
• Viral culture

Correct Answer: HIV DNA PCR

Q8. In a national rapid testing algorithm, a positive HIV diagnosis generally requires:

• One reactive rapid test only
• Two sequential reactive rapid tests using different test principles
• A reactive rapid test plus a CD4 count >500
• Only a clinician’s assessment without tests

Correct Answer: Two sequential reactive rapid tests using different test principles

Q9. What is the current primary role of CD4 testing in many programs where viral load is available?

• Routine primary monitoring for treatment response
• Staging, baseline assessment and opportunistic infection risk assessment
• Replacing viral load for suppression assessment
• Drug resistance testing

Correct Answer: Staging, baseline assessment and opportunistic infection risk assessment

Q10. Which pharmacist‑led intervention most directly improves ART adherence and viral suppression?

• Competitor drug marketing
• Medication counseling and adherence tools (pillboxes, SMS reminders)
• Only dispensing medicines without counseling
• Reducing visit frequency without support

Correct Answer: Medication counseling and adherence tools (pillboxes, SMS reminders)

Q11. Pharmacovigilance in HIV programs primarily monitors for:

• Supply chain lead times
• Adverse drug reactions and long‑term toxicity of ARVs
• Number of clinic appointments
• Healthcare worker salaries

Correct Answer: Adverse drug reactions and long‑term toxicity of ARVs

Q12. In ARV supply chain management, ‘buffer stock’ is used to:

• Increase pricing
• Absorb supply disruptions and prevent stock‑outs
• Eliminate need for forecasting
• Reduce storage requirements

Correct Answer: Absorb supply disruptions and prevent stock‑outs

Q13. Which group is typically classified as a ‘key population’ for targeted HIV interventions?

• School‑age children who are HIV‑negative
• People who inject drugs, sex workers, men who have sex with men
• General population with low risk
• Health administrators only

Correct Answer: People who inject drugs, sex workers, men who have sex with men

Q14. Pre‑exposure prophylaxis (PrEP) commonly uses which drug combination for oral prevention?

• AZT + 3TC
• TDF + FTC (or TDF + 3TC)
• LPV/r + TDF
• EFV monotherapy

Correct Answer: TDF + FTC (or TDF + 3TC)

Q15. In program evaluation, HIV ‘incidence’ measures:

• Total number of people living with HIV at a time
• Number of new HIV infections over a defined period
• Number of ART clinics in a region
• Number of viral load tests performed

Correct Answer: Number of new HIV infections over a defined period

Q16. Sentinel surveillance differs from case‑based surveillance in that sentinel systems:

• Collect detailed data on every diagnosed case
• Use selected sites to monitor trends and prevalence
• Are used only for vaccine‑preventable diseases
• Eliminate the need for routine reporting

Correct Answer: Use selected sites to monitor trends and prevalence

Q17. For TB/HIV co‑infection, which preventive therapy is commonly offered to people living with HIV to reduce TB risk?

• Isoniazid preventive therapy (IPT)
• Fluconazole prophylaxis
• Oseltamivir therapy
• Acyclovir prophylaxis

Correct Answer: Isoniazid preventive therapy (IPT)

Q18. The HIV treatment cascade (continuum of care) typically includes which sequential indicators?

• Diagnosed → Linked to care → On ART → Retained → Virally suppressed
• Tested → Vaccinated → Discharged → Returned
• Screened → Quarantined → Treated → Released
• Registered → Transferred → Archived → Deleted

Correct Answer: Diagnosed → Linked to care → On ART → Retained → Virally suppressed

Q19. A recommended action after a single elevated viral load >1000 copies/mL is:

• Immediate switch to third‑line regimen
• No action unless severe symptoms occur
• Enhanced adherence counseling followed by repeat viral load after 3 months
• Stop ART for 2 weeks then restart

Correct Answer: Enhanced adherence counseling followed by repeat viral load after 3 months

Q20. Which clinically important drug–drug interaction is relevant for patients on rifampicin and dolutegravir (DTG)?

• Rifampicin increases DTG levels requiring dose reduction
• Rifampicin significantly reduces DTG levels; DTG dosing may need adjustment
• Rifampicin has no interaction with DTG
• DTG inactivates rifampicin

Correct Answer: Rifampicin significantly reduces DTG levels; DTG dosing may need adjustment

Q21. How can pharmacists contribute directly to improving viral suppression rates?

• By limiting patient counseling to pharmacists only
• By ensuring timely dispensing, adherence support, and adverse effect management
• By prescribing second‑line ART without tests
• By reducing drug stock levels to control usage

Correct Answer: By ensuring timely dispensing, adherence support, and adverse effect management

Q22. Genotypic resistance testing is most useful when:

• A patient has virologic failure despite good adherence and resources allow testing
• Baseline before starting any ART in resource‑limited settings is mandatory
• Used routinely every month
• Used only for HIV prevention programs

Correct Answer: A patient has virologic failure despite good adherence and resources allow testing

Q23. Which community‑based model increases HIV testing coverage among hard‑to‑reach groups?

• Facility‑only testing during weekdays
• Mobile/outreach rapid testing and peer‑led testing
• Testing only through tertiary hospitals
• Testing after a year of symptoms

Correct Answer: Mobile/outreach rapid testing and peer‑led testing

Q24. Post‑exposure prophylaxis (PEP) for non‑occupational exposure should be started within what timeframe?

• Within 24 hours only
• Within 72 hours
• Within 7 days
• Anytime within a month

Correct Answer: Within 72 hours

Q25. For a healthcare worker with a needle‑stick from an HIV‑positive source, the immediate pharmacist‑relevant action is:

• Delay any action until test results return
• Provide or arrange immediate PEP and counsel about adherence and follow‑up testing
• Advise to stop working permanently
• Provide antibiotics instead of ARVs

Correct Answer: Provide or arrange immediate PEP and counsel about adherence and follow‑up testing

Q26. Tenofovir disoproxil fumarate (TDF) use requires caution in patients with:

• Renal impairment and low eGFR
• Well controlled hypertension only
• High bone mineral density
• No drug interactions

Correct Answer: Renal impairment and low eGFR

Q27. Most oral ARV formulations should generally be stored:

• In a freezer at −20°C
• At controlled room temperature, protected from excessive heat and moisture
• Exposed to direct sunlight for activation
• In an oxygen‑free container

Correct Answer: At controlled room temperature, protected from excessive heat and moisture

Q28. UNAIDS ’95‑95‑95′ targets for epidemic control mean by 2030:

• 95% vaccinated, 95% treated, 95% cured
• 95% diagnosed, 95% of those on ART, 95% of those virally suppressed
• 95% of clinics have ART, 95% have staff, 95% have supplies
• 95% reduction in new infections annually

Correct Answer: 95% diagnosed, 95% of those on ART, 95% of those virally suppressed

Q29. The WHO validation threshold for elimination of mother‑to‑child transmission in non‑breastfeeding populations is a transmission rate of less than:

• 10%
• 5%
• 2%
• 0.5%

Correct Answer: 2%

Q30. High‑quality program data for case management is best supported by which system feature?

• Paper registers without identifiers
• Unique patient identifiers and electronic case‑based surveillance with routine data quality checks
• Only aggregate annual reports
• Ad hoc verbal reports without documentation

Correct Answer: Unique patient identifiers and electronic case‑based surveillance with routine data quality checks

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