AIDSinfo logo

HIV Treatment

Just Diagnosed: Next Steps After Testing Positive for HIV

(Last updated 4/30/2015; last reviewed 4/30/2015)

Key Points

  • Testing positive for HIV often leaves a person overwhelmed with questions and concerns. It’s important to remember that HIV is a manageable disease that can be treated with HIV medicines. HIV medicines can’t cure HIV, but they help people with HIV live longer, healthier lives.
  • The first step after testing HIV positive is to see a health care provider, even if you don’t feel sick. Prompt medical care is the best way to stay healthy.
  • People with HIV work closely with their health care providers to decide when to start treatment and what HIV medicines to take. Making these decisions begins with an HIV baseline evaluation.
  • An HIV baseline evaluation includes a review of the person’s health and medical history, a physical exam, and lab tests. 
  • Results from an HIV baseline evaluation are used to decide whether a person is ready to start lifelong treatment with HIV medicines, and, if so, what HIV medicines to start.

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 is a manageable disease that can be treated with HIV medicines. HIV medicines can’t cure HIV, but they help people with HIV live longer, healthier lives.

The first step after testing positive is to see a health care provider, even if you don’t feel sick. Prompt medical care is the best way to stay healthy.

People with HIV work closely with their health care providers to decide when to start treatment and what HIV medicines to take. Making these decisions begins with an HIV baseline evaluation.

What is an HIV baseline evaluation?

An HIV baseline evaluation includes all the information collected during a person’s initial visits with a health care provider. The HIV baseline evaluation includes a review of the person’s health and medical history, a physical exam, and lab tests.

The purpose of an HIV baseline evaluation is to:

  • Determine how far a person’s HIV infection has progressed. Treatment with HIV medicines can prevent the progression of HIV to AIDS. AIDS is the final stage of HIV infection.
  • Evaluate the person’s readiness to start lifelong treatment with HIV medicines.
  • Collect information to decide when to start HIV medicines and what medicines to start.

During an HIV baseline evaluation, the health care provider explains the benefits and risks of HIV treatment and discusses ways to reduce the risk of passing HIV to others. The health care provider also takes time to answer any questions.

What are some questions people typically ask during their first visits with an HIV health care provider?

People newly diagnosed with HIV infection have many questions. If you’ve just tested HIV positive you may have some of the following questions:

  • Because I have HIV, will I eventually get AIDS?
  • What can I do to stay healthy and avoid getting other infections?
  • 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?
Many people find it helpful to write down questions before a medical appointment. Some people bring a family member or friend to their HIV appointments to remind them of questions to ask and to jot down the answers.

What lab tests are included in an HIV baseline evaluation?

The following lab tests are included in an HIV baseline evaluation.

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. HIV destroys CD4 cells, which damages the immune system. A damaged immune system makes it hard for the body to fight off infections. Treatment with HIV medicines (called antiretroviral therapy [ART]) prevents HIV from destroying CD4 cells.

ART is recommended for everyone with HIV, but the need to start ART is greater in people with low or rapidly falling CD4 counts. A falling CD4 count indicates that HIV is advancing and damaging the immune system.

The CD4 count is also used to monitor the effectiveness of HIV medicines once ART is started.

Viral load
A viral load test measures how much virus is in the blood (HIV 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. A high viral load increases the urgency to start ART.

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

Testing for sexually transmitted infections (STIs)
Coinfection with another STI can cause HIV infection to advance faster and increase the risk of HIV transmission to a sexual partner. STI testing makes it possible to detect and treat any STIs promptly.

An HIV baseline evaluation also includes other tests, such as a blood cell count, kidney and liver function tests, and tests for hepatitis.

How does an HIV baseline evaluation help determine if a person is ready to start HIV treatment?

Before starting treatment, people with HIV must be prepared to take HIV medicines every day for the rest of their lives. A baseline evaluation can help to identify any issues that can make it difficult to take HIV medicines every day and exactly as prescribed (called medication adherence). Issues, such as lack of health insurance or alcohol or drug abuse can make medication adherence difficult. Health care providers can recommend resources to help people deal with any issues before they start taking HIV medicines.

How can I find more resources for a person who has just tested HIV positive?


This fact sheet is based on information from these sources: