What is the next step after a positive HIV test result?

A positive HIV test result often leaves a person overwhelmed with questions and concerns. It is important to remember that HIV infection can be treated effectively with the drugs used to fight it.

Treatment with anti-HIV drugs (called antiretroviral therapy or ART) is recommended for all HIV-positive people. These drugs help them live longer and 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. The best way to stay healthy is to get medical care and treatment with HIV drugs as soon as possible.

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

After receiving positive HIV test results, a person’s first visit with a health care provider includes an examination of their health and medical history, a physical exam, and various laboratory tests.

The information collected during a person’s initial consultation is used to make decisions about the treatment of HIV infection.

What laboratory tests are used to make decisions about the treatment of HIV infection?

A health care provider reviews the results of a person’s lab tests to:

The results of the three lab tests listed below help answer those questions.

CD4 lymphocyte count
A CD4 lymphocyte count measures the number of CD4 lymphocytes in a blood sample. CD4 lymphocytes are cells of the immune system that fight infection. HIV destroys CD4 lymphocytes, thereby damaging the immune system. As HIV infection progresses, a person’s CD4 cell count drops, indicating more damage to the immune system. Treatment with HIV drugs prevents the virus from destroying CD4 cells.

Viral load
A viral load test measures the concentration of the virus in the blood (viral load). As HIV infection turns into AIDS, a person’s viral load increases. The drugs used to combat it prevent the multiplication of the virus, which reduces the viral load of the person. One goal of HIV treatment is to keep a person’s viral load so low that the virus cannot be detected by a viral load test. This is known as an undetectable viral load.

Once treatment for HIV infection is started, the CD4 count and viral load are used to determine if the drugs used to fight HIV are actually controlling the person’s infection.

Drug resistance test (drug resistance)
Health care providers take into account many factors, including the results of a person’s drug resistance test, when recommending drugs for HIV infection. Drug resistance testing identifies which HIV drugs, if any, will not be effective against a person’s strain of HIV.

What do my lab results mean? provides more information on the tests used to monitor HIV infection and treatment for it.

After testing positive for HIV, how soon do people start taking medicines to fight the infection?

HIV-positive people should start taking HIV medicines as soon as possible after they are diagnosed with the infection. However, before starting treatment, you should be prepared to take these medications daily for the rest of your life.

Some situations, such as the lack of health insurance or the inability to pay for HIV medicines, can make it difficult for people to take them consistently. Health care providers can recommend resources to help people deal with any problems before starting HIV medications.

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

Yes, an initial consultation with a health care provider is a good time to ask questions. The following are some questions that people with a new diagnosis of HIV infection often ask:

Since I have HIV, will I ever have AIDS?
What can I do to stay healthy and avoid getting other infections?
How can I avoid passing HIV to other people?
How will HIV treatment affect my lifestyle?
How should I tell my partner that I have HIV?
Is there a reason to tell my employer and my co-workers that I have HIV?
Are there support groups for people with HIV?
Are there resources available to help pay for my HIV medications

Where can I find more resources for a person who has just been diagnosed with HIV infection?

The following are resources to share with a person newly diagnosed with HIV infection:

Finding HIV Treatment Services, AIDS info fact sheet citing various resources related to HIV infection, including some to help you find a health care provider and get help paying for HIV medicines.
How to Tell Others, a website that offers tips on how to share an HIV diagnosis with others, from the Centers for HIV Prevention and Control
Questions for My Appointment, Agency for Healthcare Research and Quality document to prepare a list of questions for a health care provider