To protect your immune system and maintain your health and wellbeing, it is recommended that you have regular medical monitoring at an HIV specialist centre (this is often referred to as an HIV clinic). This monitoring will measure the health of your immune system and help show the best time for you to start HIV treatment. Once you are on treatment, these checks will monitor how well the treatment is working.

You can play an active role in your health care at your regular clinic appointments. It’s useful to think about how you have been, what is working well for you and what is not working so well, in advance of the appointment. This will help you raise any concerns or queries. It might be a good idea to note down any questions you have between appointments, so you remember to ask them at your next appointment.

The most important blood tests in monitoring HIV are CD4 cell counts (to measure the strength of your immune system) and HIV viral load tests (to measure the levels of virus in the blood). See NAM’s booklet CD4, viral load & other tests for more information.

Your CD4 cell count may go up or down with your menstrual cycle, or during times you feel ‘run down’ or unwell. The oral contraceptive pill may lower your CD4 cell count, but not to such an extent that your health could be at risk. Pregnancy can lower your CD4 cell count too; this is due to the effect of having a larger blood volume in your body while you are pregnant, but it should not affect your immune system’s health. After the baby is born, the CD4 count usually goes back to the same level as before you became pregnant.

Once you are taking treatment, you and your doctor will usually be more interested in looking at the result of your viral load test – ideally, treatment should suppress the virus, so your viral load stays very low.