Taking the Next Steps in HIV Care After Viral Suppression

For anyone living with HIV, working with a healthcare provider is essential to staying as healthy as possible.

People living with HIV have all the same health concerns as people without HIV, including blood sugar, cholesterol, blood pressure, and other important markers of overall health.

Treating human immunodeficiency virus (HIV) is a lifelong process. The first part of that process is starting treatment. The standard of treatment for HIV is antiretroviral therapy, often called ART. While this treatment cannot cure HIV, it can suppress the amount of the virus in the body to very low levels—in many cases, levels that are undetectable by standard blood tests.

Continuous treatment with ART allows the immune system to remain healthy. It allows a person to avoid AIDS (acquired immunodeficiency syndrome). It helps avoid transmitting the virus to other people. It gives a person with HIV the opportunity to live a long and healthy life.

If you’re living with HIV and have already achieved viral suppression, it’s normal to wonder what comes next. While this answer will be a bit different for every person, below are a few ideas about what to discuss with your healthcare provider to find out what that answer looks like for you.

Your best source of information

Your best source of information about your health will be your healthcare provider. HIV is typically treated by a medical doctor who specializes in infectious diseases, or in some cases, by a primary care provider who has experience treating HIV.

For many people living with HIV, the healthcare provider who oversees their HIV care also acts as a primary care provider—the provider who oversees preventive care, addresses common medical problems (like an injury or illness), and coordinates with other healthcare providers you may need.

Here are some questions that you can discuss with your healthcare provider when determining your next steps in treatment.

  • Do you have any other conditions or infections that require treatment?
  • What can you do to prevent transmitting HIV to others?
  • What foods should you be eating? What foods should you be avoiding?
  • How physically active are you? What types of exercise should you be doing? Are there any activities you should avoid?
  • Are there any unhealthy habits that you need to address? This can include everything from smoking and substance use, to eating too much junk food.
  • Where does mental health fit into your treatment plan? How has HIV affected things like your thoughts, moods, social life, and emotions?

Treating HIV can feel all encompassing—and taking every dose of your medication is the most important thing you can do for your health. But it’s also important that you do not lose sight of all the other aspects of your health and healthcare.

Health concerns when living with HIV

People living with HIV have all the same health concerns as people without HIV. They require regular checkups to monitor blood glucose levels, cholesterol, blood pressure, and other important markers of overall health and disease risk.

People living with HIV are also at an increased risk for numerous conditions, especially as they get older. This list includes cardiovascular disease, type 2 diabetes, kidney disease, liver disease, and certain cancers. It also includes HIV-associated dementia (HAD) and HIV-associated neurocognitive disorder (HAND), a collection of problems that affect the nervous system and brain, and can cause problems with memory, thinking, mood, and motor skills. The increased risk of these conditions is thought to be caused by low levels of chronic inflammation that occur as a result of HIV infection.

Again, your healthcare provider will be your best source of information—and it’s always worth discussing the risk and prevention of these conditions sooner than later.

Article sources open article sources

UpToDate. Patient education: Initial treatment of HIV (Beyond the Basics).
Centers for Disease Control and Prevention. HIV Treatment. How Do You Get Your Viral Load to Undetectable and Keep It There?
Centers for Disease Control and Prevention. ART Adherence.
Sampath Wijesinghe and Jeffrey L. Alexander. Management and treatment of HIV: are primary care clinicians prepared for their new role?
MBC Family Practice, 2020. Vol. 21.
Seetha Lakshmi, Susan E. Beekmann, et al. HIV Primary Care by the Infectious Disease Physician in the United States - Extending the Continuum of Care. AIDS Care, 2017. Vol. 30, No. 5.
MedlinePlus. Choosing a primary care provider.
National Institutes of Health. HIV and Nutrition and Food Safety. Exercise and Physical Activity.
National Institutes of Health. HIV and Substance Use.
Centers for Disease Control and Prevention. HIV Stigma and Mental Health. Aging with HIV.
Johns Hopkins Medicine. HIV and Dementia. Other Health Issues of Special Concern for People Living with HIV.

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