A Demonstration Project to Add Pre- or Post-exposure Prophylaxis to Combination HIV Prevention Services

Inclusion Criteria: * At least 18 years of age * Able to understand and provide consent in English or Spanish * Self identified MSM, MSM/W, or Transfemale * At least one male sex partner for anal intercourse in the prior 12 months * HIV negative by enzyme immunoassay (EIA) and viral load (VL) * CrCl ≥ 60 ml/min (via Cockcroft-Gault formula) * No signs or symptoms suggestive of primary HIV infection (PHI). Exclusion Criteria: * Participants \<18 years of age * Unable to understand and provide consent in English or Spanish * Known or found on testing to be HIV positive * Any condition, which in the opinion of the intake provider, will seriously compromise the participant's ability to comply with the protocol, including adherence to PEP or PrEP medication dosing * Use of Antiretroviral therapy (ART) taken for any indication (i.e. PEP or PrEP) within 60 days of study entry * Previous participation in an HIV vaccine trial. Participants that were documented to have received only placebo are not excluded. * Signs or symptoms suspicious for PHI.