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The HIV care pathway

What is HIV?

If you are 'HIV positive' this means that you have a virus called HIV in your body.

It doesn't necessarily mean that you are ill, or that you have AIDS, or that you are dying.

HIV slowly attacks the immune system, which is the body's natural defence system against infections. If the immune system is weak, there is a risk of getting ill from different infections.

At some stage you may need drug treatments to stay in good health. They can stop HIV reproducing, and so limit the damage to the immune system.

'AIDS' is different from HIV. AIDS is an advanced stage of infection when the immune system is very weak. Thanks to medicines, few people now get AIDS, and they can often recover from it.

My test is positive

If you are given an HIV positive result, you will:

  • Have a post test discussion with a health adviser where any questions you have will be addressed. You will be given reassurance and information, and we will also tell you how your care from this point will continue.

  • If you feel able to cope on that day, you will also meet the HIV nurses who can offer further information, reassurances and who will take some baseline blood tests so we can assess your general health.

  • You will be given an appointment in two weeks time to see a doctor. At the appointment, your doctor will discuss your blood test results and perform a general examination.

  • You will see the HIV nurses again. They will do some more blood tests to check the viral load level in your blood as well as your Immune system.

Keeping an eye on your health

From someone's physical appearance, you can't tell if they have HIV or not. And you can't always know how good their health is.

But blood tests can show how HIV is affecting your health. Even if you're not taking treatments, it's important to have two blood tests done regularly.

The first is called the CD4 count and is a measure of the strength of your immune system. When the immune system is strong, the CD4 count is higher.

The second is the viral load test. It's a measure of the number of copies of HIV in a sample of blood. The lower it is, the better.

You'll probably be asked to have these tests done every few months. They will help you and your doctor make decisions about your health.

Do I need to take treatments?

The drugs used to treat HIV are often called 'combination therapy'. That's because people usually take a combination of three drugs at the same time.

Not everybody with HIV needs to take combination therapy straightaway.

It's different for different people:

  • If your CD4 count is high and HIV is not making you ill, then treatment may not be recommended.

  • If your CD4 count is low or HIV is making you ill, your doctor may recommend that you start treatment.

If HIV is making you ill, doctors call this 'symptomatic'. If it's not making you ill, it's 'asymptomatic'. Deciding to start treatment also depends on your feelings. Give yourself enough time to find out about your options and make your own mind up.

If we find that your CD4 is less than 200, you will be given some antibiotics to protect you from a serious chest infection.

Your CD4 and viral load results will determine whether or not you need to start treatment or not, as well as your future care.

Some people do not need treatment for many years.

Importantly, we need to monitor you regularly - whether you are on treatment or not - and it is essential that you attend further appointments.

Key staff

Members of the team in the sexual health clinic at St Helier Hospital include:

Consultant physicians
Clinical nurse specialists HIV
Health advisors
Clinical psychologist
HIV specialist pharmacist
Community clinical nurse specialist HIV
Voluntary sector workers

More information

Your next steps - a brochure from the Terrence Higgins Trust about living with HIV

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