What is the next step 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 can be treated effectively with HIV medicines.

Treatment with HIV medicines (called antiretroviral therapy or ART) is recommended for everyone with HIV. HIV medicines help people with HIV live longer, healthier lives and reduce the risk of HIV transmission.

The first step after testing positive for HIV is to see a health care provider, even if you don’t feel sick. Prompt medical care and treatment with HIV medicines as soon as possible is the best way to stay healthy.

After testing positive for HIV, what can a person expect during their first visit with a health care provider?

After testing positive for HIV, a person’s first visit with a health care provider includes a review of the person’s health and medical history, a physical exam, and several lab tests. The health care provider also explains the benefits of HIV treatment and discusses ways to reduce the risk of passing HIV to others.

The information collected during a person’s initial visit is used to make decisions about HIV treatment.

Which lab tests are used to make decisions about HIV treatment?

A health care provider reviews a person’s lab test results to:

  • Determine how far the person’s HIV infection has advanced (called HIV progression)
  • Decide which HIV medicines to recommend

Results from the following three lab tests help answer these questions.

CD4 count
A CD4 count measures the number of CD4 cells in a sample of blood. CD4 cells are infection-fighting cells of the immune system. As HIV advances, a person’s CD4 count drops, which indicates increasing damage to the immune system. Treatment with HIV medicines prevents HIV from destroying CD4 cells.

Viral load
A viral load test measures how much virus is in the blood (HIV viral load). As HIV progresses to AIDS, a person’s viral load increases. HIV medicines prevent HIV from multiplying, which reduces a person’s 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. This is known as having an undetectable viral load.

Once HIV treatment is started, the CD4 count and viral load are used to monitor whether the HIV medicines are controlling a person’s HIV.

Drug-resistance testing
Health care providers consider many factors when recommending HIV medicines, including a person’s drug resistance test results. Drug-resistance testing identifies which, if any, HIV medicines will not be effective against a person’s strain of HIV.

The AIDSinfo infographic What do my lab results mean? has more information about tests used to monitor HIV infection and treatment.

After testing positive for HIV, how soon do people start taking HIV medicines?

People with HIV should start taking HIV medicines as soon as possible after their HIV is diagnosed. However, before starting treatment, people with HIV must be prepared to take HIV medicines every day for the rest of their lives.

Issues, such as lack of health insurance or an inability to pay for HIV medicines, can make it hard to take HIV medicines consistently. Health care providers can recommend resources to help people deal with any issues before they start taking HIV medicines.

During a person’s first visit with a health care provider is there time to ask questions?

Yes, an initial visit with a health care provider is a good time to ask questions. The following are some questions that people with newly diagnosed HIV typically ask:

  • 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?
  • Are there resources available to help me pay for my HIV medicines?

Where can I find more resources for a person just diagnosed with HIV?

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.
  • Telling Others, a webpage with information on how to share an HIV diagnosis with others, from the Centers for Disease Control and Prevention.