Basic management and monitoring of HIV infection

Once HIV infection is diagnosed, a person has a life-long condition which will go through several stages and has many consequences. The disease needs to be managed by people with HIV themselves as well as their healthcare providers.

An overview of the needs of a person with HIV infection (not necessarily in order of priority) is as follows:

1. Education / information - learning how to best take care of yourself, staying informed about new treatments or approaches
   
2. Maintaining general health - self care, nutrition
   
3. Financial planning - medical aid, future provision for self and dependents
   
4. Monitoring HIV disease - regular medical check-ups, monitoring tests
   
5. Preventing opportunistic disease - avoiding exposure, alertness to early signs of disease, prophylactic medication
   
6. Psychological health - informing others, dealing with stigma, spiritual support, managing anxiety and depression
   
7. Sexual and reproductive - safer sex for partners and self, whether to have a baby, avoiding infection of the baby
   
8. Antiretroviral treatment
   
9. Terminal care - care and treatment during the final stages of the disease.
   

Monitoring HIV disease

A person with HIV should see a healthcare provider regularly, which may be as little as twice a year if you have no symptoms and are coping well, or more frequently - perhaps four times a year if symptoms have started and antiretroviral treatment is being taken, or as frequently as required when very ill (daily or weekly).

Even if you are fairly well, these regular visits to your healthcare provider are important because they may lead to new conditions being detected and treated early on, before they become dangerous or beyond treatment. Also, it allows your healthcare provider to start preventative treatments (prophylactic medication) in good time.

At each visit, a medical history should be taken of symptoms or other problems, followed by a physical examination to look for signs of HIV related disease.

The physical examination would usually include:

• Checking body weight
  
• Inspection and/or palpation (feeling) of
  o Skin
  o Mouth and teeth
  o Lymph nodes
  o Respiratory system
  o Abdomen
  o Genitals
  
• Eyes: eyesight can be tested by reading from a chart, and the back of the eye (retina) can be examined using a special torch (opthalmoscope).