What Can You Expect at Your First HIV Medical Visit?
Just like with many other chronic health conditions, seeing a health care provider for the first time about HIV might make you a bit nervous. But you’re taking an important first step: by taking HIV medicine (called antiretroviral therapy or ART) as prescribed and staying in ongoing medical care, you can live a long, healthy life.
During your first appointment, your health care provider will talk to you about HIV and answer any questions you may have. They will help you understand how HIV works in your body, your treatment options, how to prevent passing HIV to others, and the importance of getting and keeping an undetectable viral load. They will also take a complete medical history, conduct a physical exam and mental health assessment, and run some lab tests. You and your provider will also discuss starting HIV medicine if you haven’t already.
When taking your medical history, your health care provider may ask questions about your:
- HIV-related history (e.g., your approximate date of diagnosis, approximate date of HIV acquisition, etc.)
- Medical, surgical, and psychiatric (mental health) history
- Medication and allergy history
- Sexual health history, including any previous diagnosis of other sexually transmitted infections (STIs)
- Substance use history
- Social, family, and travel history
- Immunization status
Your provider will also ask about any recent or new symptoms that you have been experiencing that may be related to HIV. (Read about HIV-related symptoms.)
During your physical exam, your provider will check your height and weight, measure your vital signs (pulse rate, temperature, blood pressure, etc.), and examine your general body appearance.
They will also examine your skin; eyes, ears, and throat; heart and lungs; genitals/rectum; and other parts of your body.
Mental Health Assessment
Your provider will also assess your mental and emotional health. They may also assess your need for supportive services and make referrals to assist you with any mental health or substance use issues, transportation, or housing needs.
After these assessments, your provider may:
- Give you any vaccines you may need, or prescribe medicine to prevent opportunistic infections.
- Refer you to specialty care (e.g., gynecology, colorectal care, etc.) if you need it.
Your health care provider will review results from any lab tests that have already been completed and run some new lab tests to find out what stage of HIV you are in, screen for other diseases, and assist in the selection of your HIV medicines. These lab tests include:
- A CD4 cell count measures how many CD4 cells are in your blood. CD4 cells are infection-fighting cells in your immune system. HIV attacks and destroys them. If too many CD4 cells are lost, your immune system will have trouble fighting off infections. A CD4 cell count is a good measure of how well your immune system is working and your risk of opportunistic infections. You want your CD4 cell count to be high.
- An HIV viral load test measures the amount of HIV in your blood. When your viral load is high, you have more HIV in your body. This means your immune system is not fighting HIV very well. HIV viral load tests are used to diagnose recent HIV infection and guide your treatment choices. In follow-up visits, viral load tests will help monitor how well your treatment is working. Once you start HIV medicine, you want your viral load to decrease and stay low.
- HIV resistance testing helps you and your provider better understand which HIV medications will work best for your HIV infection.
Your lab test results, along with your medical history, physical exam, mental health assessment, and other information you provide will help you and your provider work together to manage your HIV care.
Your health care provider will repeat some of these lab tests as part of your ongoing HIV care to see how well your HIV medicine is working so that you can get the virus under control, protect your health, and prevent transmitting the virus to others.
Start HIV Treatment
If you started HIV treatment immediately upon your diagnosis and are now seeing your health care provider for the first time for a full assessment, talk about your experience with taking the medicine so far (side effects, any problems taking doses on time, etc.)
If you are not already on HIV treatment, you and your health care provider will discuss starting treatment. It is recommended that you start it as soon as you possibly can. The sooner you start to take HIV treatment, the sooner you can benefit from it. Research shows that people who start treatment earlier are less likely to get ill or to pass HIV on to other people.
While starting HIV treatment as soon as possible after diagnosis is recommended, the decision to start treatment rests with you. Before starting treatment, talk with your health care provider about how you are feeling. Discuss your readiness to start HIV treatment, the benefits of starting now, and what drug regimens are recommended for you. Also ask your provider about how to take the HIV medicine and what side effects you may experience.
Schedule Follow-up Appointments
Talk to your provider about when you should return for follow-up visits and where you can learn more about HIV. Staying informed about your HIV care and treatment and partnering with your health care provider are important steps in managing your health and HIV care. Learn more about making care work for you.