28
Treatment
Table 5. Routine Healthcare Maintenance for People With
HIV (After Initial Assessment)
Intervention Recommendation Comments
Screening for and Prevention of Cancer (cont'd)
Cervical cancer
screening
Age <21: Pap within 1 year of
sexual activity, no later than age 21.
Age 21–29: Pap at diagnosis of
HIV, repeat yearly × 3, then if all
normal—Pap every 3 years.
Age <30 years: No HPV testing
unless abnormalities are found on
Pap test.
Age ≥30 years: Pap only, same as
21–29 years.
OR
Pap with HPV testing. If both neg
THEN
Pap with HPV every 3 years.
Note: In general, continue screening
past 65 years.
Abnormal Pap and/or HPV
follow-up similar to general
population. See Section II
for further discussion.
Anal cancer
screening
Digital anorectal exam: Perform at
least annually if asymptomatic.
Anal Pap: ere are no national
guidelines at this time. Some
experts recommend anal cytolog y
for persons with HIV who have
receptive anal sex, but only if high-
resolution anoscopy is available.
Abnormal anal Pap should
prompt referral for high-
resolution anoscopy.
Hepatocellular
carcinoma
screening
Alpha-fetoprotein (AFP) and liver
ultrasound every 6 months.
For patients with cirrhosis
for any cause or chronic
hepatitis B.
Other Healthcare Maintenance
Complete blood
count and
chemistry panel
Perform as needed based upon
underlying conditions and need for
toxicity management for ART and
other medications.
—
(cont'd)