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What is an appropriate level of HIV care?
Jun 15, 2012

Dr Young,

I tested positive for HIV two years ago. I am currently being treated with Atripla and have an undetectable viral load and CD4 count that averages about 500 (sometimes a little above, sometimes a little below) with a cd4% about 35%. I am also being treated for high grade anal dysplasia and go in for an HRA ever 6 months to monitor.

My question is, when I see my HIV specialist, what kind of exam should be done and how often should I go? I currently go every 6 months and my appointments on average only last 15 minutes. Usually we go over my lab results, he says "your doing great" and that about covers it. He has not done a complete phsyical since I was diagnosed. How often should someone on stable therapy be seen and what should the appointments consist of?

Response from Dr. Young

Hello and thanks for posting.

You raise a question of increasing relevance-- as people living with HIV are living better and with fewer AIDS-related complications, there's a growing question as to which type of healthcare provider does what part of the health monitoring.

For example, some HIV care providers serve both the primary and HIV-specialty care, whereas some only do the HIV care, deferring the primary care to GPs. Do you have a primary care doctor, or does your HIV doctor provide all services? It would be reasonable to have a baseline examination; alternatively, if you were diagnosed two years ago, it might only be that you've missed on annual exam.

Seems like time for a simple conversation and question to your doctor.


If the answer is the later, then the typical would be to have a "complete physical" once a year, with the other visits to be "symptom prompted".

Stubborn gut
Steroids and Atripla

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