A 31-year-old man who lives in Indianapolis, Indiana is seen in an HIV clinic after being out of clinical care for about 18 months. He is asymptomatic and not taking any medications. Laboratory studies show a CD4 count of 109 cells/mm³ and an HIV RNA of 91,240 copies/mL. He is seen back at the clinic 2 days later with a plan to start antiretroviral therapy and trimethoprim-sulfamethoxazole. Because this individual lives in an area highly endemic for histoplasmosis and has CD4 count less than 150 cells/mm³, the decision is made to start prophylaxis for histoplasmosis.