Key Points
2
➤ This guidance from an expert panel of the HIV Medicine Association
(HIVMA) of the Infectious Diseases Society of America (IDSA) updates
the 2013 HIV primary care guidelines.
➤ These recommendations encompass the comprehensive care of
persons with HIV, including comorbidity management.
I. OPTIMIZING CARE ENGAGEMENT, MEDICATION
ADHERENCE, AND VIRAL SUPPRESSION
1. All persons with HIV should be provided timely access to routine and
urgent primary medical care, including approaches to expand access
such as extended/weekend hours or telehealth.
2. HIV care sites should make every effort to provide care in a way that
is linguistically and culturally appropriate.
3. HIV care sites should implement programs incorporating evidence-
based and evidence-informed interventions shown to improve HIV
care engagement and viral suppression.
4. HIV care sites should utilize a multidisciplinary model but identify
a primary clinician for each patient and support the development of
trusting, long-term, patient-clinician relationships.
Diagnosis
II. INITIAL EVALUATION AND IMMEDIATE FOLLOW-UP FOR
PERSONS WITH HIV
5. A comprehensive present and past medical history including HIV-
related information, medication/social/family history (Tables 1 and
2), review of systems, and physical examination (Table 3) should
be obtained for all patients upon initiation of care, ideally at the
first visit but, if not feasible, then as soon as possible thereafter.
In particular, in settings of rapid ART initiation, clinicians may
initially truncate parts of the comprehensive history and physical,
providing a more targeted exam but with close follow-up to complete
the essential and more comprehensive assessment. Since many
patients will not be able to recall details of prior treatments and
labs, medical records should be requested and reviewed, and the
current medical record updated accordingly. Baseline laboratory
assessments should be obtained at the initial visit. (See Table 4)
