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Table 5. Routine Healthcare Maintenance for People With
HIV (After Initial Assessment)
Intervention Recommendation Comments
Screening for and Monitoring of Metabolic Disorders (See also Section IV) (cont'd)
Screening for
hyperlipidemia
Lipid profile: Perform every 5 years if
normal; more frequently if abnormal
or other cardiovascular risk factors
present (every 6–12 months). If
abnormal, repeat fasting.
Follow ASCVD Risk
calculator. Consider testing
1–3 months aer starting or
changing ART. See Section
IV for further discussion.
Screening for
diabetes mellitus
and glucose
intolerance
Serum glucose: Perform annually. If
abnormal, obtain fasting glucose.
Hemoglobin A1C should be
obtained prior to initiation of ART,
if possible. In persons with diabetes,
repeat at least every 6 months (more
frequently if clinically indicated).
Urine microalbumin or urine
protein/creatinine ratio: In patients
with diabetes, repeat at least every 6
months (more frequently if clinically
indicated).
Consider testing 1–3
months aer starting or
changing antiretroviral
medications. HbA1c is not
used to diagnose diabetes
in persons on ART. It may
be used for screening and
monitoring. Consider
threshold cutoff of 5.8%.
See Section IV for further
discussion.
Screening for
bone mineral
density
Baseline bone densitometry by
dual-energ y X-ray absorptiometry
(DXA) should be performed in all
postmenopausal women and men
aged ≥50 years.
See Section IV for further
discussion.
Screening and Vaccination for Infectious Diseases
Syphilis screening Perform at least annually in
asymptomatic persons. Repeat
every 3–6 months in asymptomatic
persons if risk of acquisition is high.
Acquisition risk depends
on sexual activities, use of
barrier protection, and local
prevalence.
Gonorrhea
and chlamydia
screening
Perform at least annually in
asymptomatic persons. Can repeat
every 3–6 months in asymptomatic
persons if risk of acquisition is high.
Screening by NAAT at
all sites of sexual contact
(rectal, oropharyngeal,
vaginal, urine/urethral)
is recommended for all
sexually active persons
with HIV. Acquisition risk
depends on sexual activities,
use of barrier protection,
and local prevalence.
(cont'd)
