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Each HIV-infected patient initially entering into care should have a complete medical history, physical examination, laboratory evaluation, and counseling. This is to confirm the presenence of HIV, get historical and laboratory data, discuss treatment of HIV with patient, and initiate care as suggested by HIV primary care guidelines. Baseline information then is used to define management goals and plans.

The following laboratory tests should be performed for a new patient during initial patient visits:

•  HIV antibody testing (if prior documentation not available) or if HIV RNA is undetectable (AI);
•  CD4 T-cell count (AI);
•  Plasma HIV RNA (viral load) (AI);
- Blood count, a chemistry profile, transaminase readings, BUN and creatinine, urinalysis, and screening test
for syphilis (e.g., RPR, VDRL, or treponema EIA), tuberculin skin test (TST) or interferon-γ release assay
(IGRA) (unless there is a history of prior tuberculosis or positive TST or IGRA), anti-Toxoplasma gondii IgG,
hepatitis A, B, and C serologies, and Pap smear in women;
• Fasting blood glucose and serum lipids if the patient is considered at risk for cardiovascular disease and for
baseline evaluation prior to initiation of combination antiretroviral therapy (AIII); and
• For patients who have pretreatment HIV RNA >1,000 copies/mL, genotypic resistance testing when the
patient enters into care, regardless of whether therapy will be initiated immediately (AIII). For patients who
have HIV RNA levels of 500–1,000 copies/mL, resistance testing also may be considered, even though
amplification may not always be successful (BII). If therapy is deferred, repeat testing at the time of
antiretroviral initiation should be considered (CIII).

People living with HIV/AIDS must often deal with several social, psychiatric, and health related issues that are best
adressed with a multidisciplinary approach to HIV. The evaluation also must include assessment of
drug abuse, economic factors (e.g., unstable housing), social support, mental illness, comorbidities, high-risk behaviors, and other factors that are known to impair the ability to adhere to treatment and to promote education about HIV Once evaluated, these factors should be managed accordingly.
Lastly,  risk behaviors and effective strategies to prevent HIV transmission. to others should be
provided at all a patient’s clinical visits.

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