It has been 120 years since the first case of AIDS was
identified. There has been a significant and dramatic
change in the management of HIV infection since the
introduction of potent antiretroviral therapy in 1996.
There has also been a significant decrease in morbidity
and mortality among persons living with HIV infection
resulting from improved access to care, prophylaxis
against opportunistic infections, and antiretroviral therapy.
A working group of clinical scientists was chosen
by the HIV Medicine Association of the Infectious Diseases
Society of America (IDSA) to develop guidelines
addressing the primary care of persons infected with
HIV. The purpose of these guidelines is to assist health
care providers in the primary care management of persons
infected with HIV, including a description of baseline
laboratory screening and adherence issues. Given
the improved survival among people living with HIV
infection, it is imperative that all persons in the United
States be managed according to standard practices appropriate for the individual’s age and sex regardless of
HIV status. In addition, HIV-infected persons require
more extensive screening and examinations than do
those without HIV infection. There are increasing reports
of complications associated with antiretroviral
therapy that may require additional and more frequenting
monitoring.
These guidelines discuss the following topics: (1)
transmission of HIV infection; (2) HIV diagnosis; (3)
risk screening; (4) management, with special sections
concerning women and children; and (5) adherence. It
is not our intent to duplicate the extensive guidelines
endorsed by the United States Public Health Service,
the Department of Health and Human Services, the
Centers for Disease Control and Prevention (CDC),
IDSA, or other accredited programs. We have referred
to these guidelines where applicable, so that this document
may also serve as a “guide to the guidelines”
(table 1). As with previously published IDSA guidelines,
we have graded our recommendations accordingly (table
2).
