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.