12
Patient Management
Table 3. Routine Health Care Maintenance in the HIV-
Infected Adult (continued)
Intervention Recommendation Comments
Colorectal
cancer screening
Perform at age 50 years in
asymptomatic patients at average
risk
More frequent testing is
indicated in patients with a
history of adenomatous polyps;
testing at an earlier age may be
advised in patients with a strong
family history of colon cancer
Mammography Perform annually in all women
age 50 years or older
Some authorities advise
initiation of screening starting at
age of40 based on an individual
risk/benefit assessment
Cervical Pap
smear
Perform annually in all women
aer two normal Pap tests
documented during the first year
following HIV diagnosis
Bone
densitometry
Perform baseline exam in
postmenopausal women and
men age 50 years or older
Detection of premature
bone loss requires periodic
monitoring thereaer; risk
factors for premature bone
loss include white race, small
body habitus, sedentary
lifestyle, cigarette smoking,
alcoholism, phenytoin therapy,
corticosteroid therapy,
hyperparathyroidism, vitamin D
deficiency, thyroid disease, and
hypogonadism
Abdominal
ultrasonography
Perform once in men age 65 to
75 who have ever smoked
Screening test for abdominal
aortic aneurysm
Patient
education
Address regularly in all patients Issues may include sexual
behavior, alcohol and drug
counseling, dietary teaching,
weight reduction, smoking
cessation, and seat belt use.
For information on digital prostate exam, prostate specific antigen, colonoscopy and mammography
see United States Preventive Services Task Force http://www.ahrq.gov/clinic/USpstfix.htm;
RPR, rapid plasma regain; STD, sexually transmitted disease; VDRL, Venereal Disease Research
Laboratory.
