Your first appointment at a specialist HIV clinic after your diagnosis (or if you change clinic) will involve questions about your health and medical history, a physical examination, and a range of tests.

Your doctor will probably ask you about the following:

• If you currently have any other physical or mental health problems, or have had any in the past.
• If you currently have any symptoms, either physical or psychological.
• If there are health conditions that affect members of your family or illnesses that run in your family; for example, heart disease, diabetes, high blood pressure, mental health problems or cancers.
• If you have a GP and whether they know your HIV status.
• If you are currently taking any medicines or drugs. This includes medicines prescribed by a doctor, those bought over the counter, alternative and herbal remedies, and recreational drugs.
• If you have had any vaccinations.
• If you have any allergies to medicines or food.
• If you smoke or drink alcohol, whether you take any exercise, and what your eating habits are like.

You will be asked about your past and current sexual activity: for example, whether you have a regular partner (and whether they know your HIV status), how many casual partners you have, the gender of your partners, whether you use condoms, and whether you have had any other sexually transmitted infections in the past. This information will help your doctor provide you with information about how you can protect your own health and the health of other people. You will have a full sexual health check as part of this visit.

Your doctor will also ask you about any children you already have or plans for having a family.

People with a cervix (women and transmen who have a cervix) will need to have a cervical screening.

At your first visit, you are likely to have a detailed physical examination. You’ll have to remove some clothing for this. If you would prefer, you can ask for the examination to be conducted by a doctor of the same sex, or for a third person to be present.

Most examinations will include checks on your height, weight, temperature, blood pressure and pulse. Your doctor will look at your whole body, and lightly touch you in various places to feel for any abnormalities, as well as using a stethoscope to listen to your breathing and heartbeat. It is also likely that your doctor will use an instrument to look into your ears, eyes, and throat. Your mouth and skin will also be checked.

If you report any symptoms, your physical examination will include a more detailed check on these.

After you have been examined, you’ll have some tests. These will mostly be done using samples of either blood or urine. Details of these tests are provided in the next section of this booklet, but at an initial visit you should have:

• a CD4 cell count
• a viral load test
• an HIV drug resistance test (see the NAM booklet Taking your HIV treatment for more information on drug resistance)
• liver and kidney function tests
• a test to look at the health of your bones
• tests to measure fats (lipids – cholesterol and triglycerides) and sugars in your blood
• a test for a particular gene (HLA-B*5701). The anti-HIV drug abacavir can cause a serious allergic reaction and it is linked to having this gene. If the test is positive you should not be prescribed abacavir.
• a full sexual health screening
• tests for infections more common in people with HIV, such as hepatitis A, B and C. They might also include other illnesses such as herpes, measles and rubella, so that you can be vaccinated against them if necessary.

You may have other tests too. Your doctor will calculate your risk of cardiovascular disease and, if you are over 50, your risk of bone fracture. Some people are referred to eye specialists for tests to identify eye infections.

If you have any symptoms, you may be asked to provide other samples. For example, if you have a cough, you may be asked to provide a sputum sample, or if you have diarrhoea, you could be asked to provide a stool sample. These will be checked in a laboratory for signs of infection.

Your clinic will have staff you can talk to about other issues raised by being diagnosed with HIV. Health advisers or other staff can help you with concerns you may have, such as disclosing your HIV status, or HIV transmission and criminal law.

If you feel you might need some additional support following your diagnosis (or at any point after that), your clinic will be able to help; it may have specialist services (such as counselling) as part of its services, or be able to refer you to them.