Just Diagnosed: Next Steps After Testing Positive For HIV
Testing positive for HIV often leaves a person overwhelmed with questions and concerns. It’s important to remember that HIV is a manageable disease that can be treated with HIV medicines.
The first step after testing positive is to see a health care provider, even if you don’t feel sick. People with HIV work closely with their health care providers to decide when to start HIV medicines and what HIV medicines to take.
The use of HIV medicines to treat HIV infection is called antiretroviral therapy (ART). People on ART take a combination of HIV medicines (called an HIV regimen) every day. ART prevents HIV from multiplying and reduces the amount of HIV in the body. ART can’t cure HIV, but it helps people with HIV live longer, healthier lives and reduces the risk of HIV transmission.
People with HIV should start ART as soon as possible. In people with HIV who have certain conditions, such as certain HIV-related illnesses and coinfections, it’s especially important to start ART right away. Deciding when to start ART and what HIV medicines to take begins with an HIV baseline evaluation.
An HIV baseline evaluation includes all the information collected during a person’s initial visits with a health care provider. The HIV baseline evaluation includes a review of the person’s health and medical history, a physical exam, and lab tests.
The purpose of an HIV baseline evaluation is to:
- Determine how far a person’s HIV infection has progressed. Treatment with HIV medicines can prevent HIV from advancing to AIDS. AIDS is the final stage of HIV infection.
- Evaluate whether the person is ready to start lifelong treatment with HIV medicines.
- Collect information to decide what HIV medicines to start.
During an HIV baseline evaluation, the health care provider explains the benefits and risks of HIV treatment and discusses ways to reduce the risk of passing HIV to others. The health care provider also takes time to answer any questions.
People with newly diagnosed HIV infection can have many questions. If you’ve just tested HIV positive you may have some of the following questions:
- Because I have HIV, will I eventually get AIDS?
- What can I do to stay healthy and avoid getting other infections?
- How can I prevent passing HIV to others?
- How will HIV treatment affect my lifestyle?
- How should I tell my partner that I have HIV?
- Is there any reason to tell my employer and those I work with that I have HIV?
- Are there support groups for people with HIV?
Many people find it helpful to write down questions before a medical appointment. Some people bring a family member or friend to their HIV appointments to remind them of questions to ask and to write down the answers.
The following lab tests are included in an HIV baseline evaluation.
A CD4 count measures the number of CD4 cells in a sample of blood. CD4 cells are infection-fighting cells of the immune system. HIV destroys CD4 cells, which damages the immune system. A damaged immune system makes it hard for the body to fight off infections. Treatment with HIV medicines prevents HIV from destroying CD4 cells. The higher a person’s CD4 count is, the better.
ART is recommended as soon as possible for everyone with HIV, no matter what their CD4 count is. However, a low CD4 count (below 200 cells/mm3) increases the urgency to start ART.
A viral load test measures how much virus is in the blood (HIV viral load). A goal of HIV treatment is to keep a person’s viral load so low that the virus can’t be detected by a viral load test.
The CD4 count and viral load test are both used to monitor the effectiveness of HIV medicines once ART is started.
Drug-resistance testing identifies which, if any, HIV medicines will not be effective against a person’s strain of HIV. Health care providers consider a person’s drug resistance test results when recommending an HIV regimen.
Testing for sexually transmitted diseases (STDs)
Coinfection with another STD can cause HIV infection to advance faster and increase the risk of HIV transmission to a sexual partner. STD testing makes it possible to detect and treat any STDs promptly.
An HIV baseline evaluation also includes other tests, such as a blood cell count, kidney and liver function tests, tests to check the levels of glucose and certain fats in the blood, and tests for hepatitis.
To learn more, view the AIDSinfo infographic: What do my lab results mean?
Before starting treatment, people with HIV must be prepared to take HIV medicines every day for the rest of their lives. A baseline evaluation can help to identify any issues that can make it difficult to take HIV medicines every day and exactly as prescribed (called medication adherence).
Issues, such as lack of health insurance or alcohol or drug use that interferes with the activities of daily life, can make medication adherence difficult. Health care providers can recommend resources to help people deal with any issues before they start taking HIV medicines.
The following are resources to share with someone with newly diagnosed HIV:
- How to Find HIV Treatment Services, a fact sheet listing HIV-related resources including resources to help find a health care provider and get help paying for HIV medicines, from AIDSinfo.
- Question Builder, a tool to use to create a list of questions to ask a health care provider, from the Agency for Healthcare Research and Quality.
- Talking About Your HIV Status, a webpage with tips on how to share an HIV diagnosis with others, from HIV.gov.
- From the Department of Health and Human Services: Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV: Baseline Evaluation, Laboratory Testing for Initial Assessment and Monitoring of Patients with HIV Receiving Antiretroviral Therapy, and Initiation of Antiretroviral Therapy
- From the Department of Veterans Affairs: Just Diagnosed
- From the Health Resources and Services Administration: Guide for HIV/AIDS Clinical Care: Testing and Assessment
Just Diagnosed: Next Steps After Testing Positive For Gonorrhea or Chlamydia
If you’ve just found out that you have gonorrhea or chlamydia, you may be trying to figure out what to do next. Here are the three most important steps that you can take:
Many people with gonorrhea and chlamydia don’t have symptoms. Why does this matter? Because an untreated infection can lead to serious and permanent health problems, even if you never have symptoms. Gonorrhea and chlamydia can be cured with the right medicine from your doctor. Just make sure you take all of your medicine exactly as your doctor tells you to.
Your regular doctor can prescribe antibiotics to cure the STD. But if you don’t have insurance or want to see someone else for treatment, there are other low-cost or free options.
Get treated at your local health department’s STD clinic, a family planning clinic, a student health center, or an urgent care clinic. You can also find a clinic using GetTested and ask if they offer treatment for gonorrhea and chlamydia.
Miracle of Love offers FREE screenings for both Gonorrhea and Chlamydia. Samples for the screenings are collected through urine and the specimens are sent to the Florida Department of Health for results. Results may take up to two weeks.
Your partner may also be infected and not know it and needs to get tested and treated. Left untreated, chlamydia and gonorrhea can cause serious health problems like PID, infertility, and potential deadly ectopic pregnancy. Also, without treatment, your partner may pass the STD back to you.
It may be emotionally uncomfortable, but telling your partners about STDs allows them to protect their health, too. Being diagnosed with an STD can cause many strong emotions. You may begin to question your trust in your partner or be worried that they will question their trust in you. Before you blame anyone, know that STDs are common and don’t always cause symptoms. It is possible that you or your partner got the STD in a previous relationship without even knowing it. Keeping that in mind, talk to your partner as soon as possible. Be honest and straightforward.
During and after your talk, your partner may also have many strong emotions. The most helpful thing you can do is listen to your partner’s concerns and fears and offer information about the STD and its symptoms and treatment. Give your partner time to absorb this information. Help your partner understand that they may also have the STD. Sometimes, no one knows for sure who had the infection first.
If you’re looking for tips on how to start the conversation with your partner, here are some resources that can help get you talking:
- Conversation Starters from the Start Talking. Stop HIV. campaign – CDC’s Division of HIV/AIDS Prevention
- Talk to Your Partner – STDs & Testing (GYT)
- Telling Your Partner You Have an STD – TeensHealth
Just like you, your partner needs to receive medical care as soon as possible. There are a number of places and ways that your partner can get medicine for gonorrhea or chlamydia:
- You can bring your partner to the clinic you went to.
- You can tell your partner to go to the clinic you went to. Your partner should tell clinic staff which infection you were diagnosed with. Sharing this information will help your partner get the correct tests and treatment.
- You may be able to get a prescription or medicine for both you and your partner from the clinic or from your doctor. This is called expedited partner therapy (EPT).
- Your partner can go to their own doctor or clinic (such as the local health department’s STD clinic, a family planning clinic, a student health center, or an urgent care clinic).
It’s common to get infected with gonorrhea and chlamydia again. Even if you and your partner took medicine, you should be retested in 3 months.
A good way to remember is to set a notification on your phone or email, ask your doctor’s office or clinic to remind you, or scribble a note on your calendar-whatever you need to do to make sure you stay healthy!
- In women, untreated chlamydia or gonorrhea can cause pelvic inflammatory disease (PID) which can lead to health problems like ectopic pregnancy (pregnancy outside the womb) or infertility (unable to get pregnant).
- In men, chlamydia and gonorrhea can each cause a painful condition in the tubes attached to the testicles. In rare cases, this may prevent him from being able to have children.
- Untreated chlamydia or gonorrhea may also increase your chances of getting or giving HIV – the virus that causes AIDS.