What to Expect at an HIV Clinic

by by Dr. Ann Avery
By: Ann Avery, Infectious Disease Physician at MetroHealth Medical Center

For many of us, making the decision to go see a health care professional about any chronic condition is tough. Believe it or not, if you’re reading this blog, you’ve already taken the first big step to seeing a specialist at an HIV clinic! Hats off to you for clicking on the link. 😊

Once you’ve read a few paragraphs into this article, you’ll feel so much more ready for that first HIV clinic visit. So, let’s dive right in!

Why should I go to an HIV clinic?

Because of the services they provide! These vary from place to place, but usually you can expect:

  • Rapid HIV testing: This is a quick screening test to check if you have HIV, and it usually involves a finger stick or mouth swab. Some clinics even offer rapid HIV testing on a walk-in basis.
  • Education: Often, you’ll get some orientation information from a member of your care team, and you’ll get a chance to ask the questions that are at the front of your mind.
  • Medical care: You’ll meet a HIV specialist, who will help you manage your prescriptions and stay consistent with taking medication.
  • Mental health: From sexual health counseling to one-on-one care, an HIV clinic is equipped to help with your mental health, too. Some HIV clinics have a behavioral health team, and others offer referrals for mental health care.

What’ll I be doing at an HIV clinic?

Usually, an HIV clinic is equipped to handle primary care alongside specialty HIV care. 🏥

Your first appointment will involve a detailed review of your medical history, and give you a chance to discuss the basics of HIV, answer your questions, and get started on HIV meds. They’ll take a blood 🩸 sample to check your viral load, T-cells, and look at other important lab values. You’ll also be offered routine vaccines that you might need. 💉

Priority number one will be getting to (and keeping) an undetectable viral load. 🥷 This means you’ll be taking HIV medication, which is the tool that gets you to U=U. Remember, Undetectable = Untransmittable (more on that here), meaning if your viral load is undetectable and has been for six months or more, you can’t pass HIV to anyone else through sex. Pretty cool, huh? 😎

What should I ask the team at an HIV clinic?

If you have questions, ask them! It can be tricky to know what to ask, though. We’ve put together some ideas. Remember, it’s okay to ask anyone on your care team for more clarity and information. Your health is important, and you deserve to be heard. 🤗

Some starter questions could be:

  • What does HIV mean?
  • How does it differ from AIDS?
  • How does my life change? (hint: not nearly as much as you think!)
  • Where can I get help when I’m away from the clinic?
  • How often do I need to come to an HIV clinic?
  • How can I make sure people around me don’t get HIV as well? (you’re already doing that by going to the clinic! But they might have more suggestions) ?
  • Do I need to use protection during sex?
  • What kind?
  • When will I know if the medication is working or if it’s doing well?
  • What are some possible side effects from the medication?
  • What is something I should look out for?
  • Can I still do physical activities or my job?

Who is on my care team?  🧑‍🤝‍🧑

Your health care team is here to support you. Just like a sports team, there will be someone in charge, kind of like a captain! In most cases, this is a physician (an MD or DO). Physicians who treat HIV are usually internal medicine or family medicine doctors. Some internal medicine doctors are subspecialized in infectious disease (ID) care. ID doctors are the ultimate HIV specialists, and it’s likely that this is who you’ll be seeing.

You also might meet another member of the care team: a physician assistant (PA) or nurse practitioner (NP). They also prescribe and treat conditions—usually less serious ones-- and are often supervised by a physician. They receive less formal training than MDs and DOs.

Here are some other members of the care team that you might meet:

  • Social workers are here to talk about adjusting to HIV and to connect you with resources. Many also offer mental health therapy.
  • Pharmacists make sure you’re on the right HIV meds, based on lab tests and other medicines you might be taking. They often provide education and check in to make sure you’re taking everything as prescribed.
  • Psychologists offer specialized counseling, and those that work in an HIV clinic are usually great at understanding how HIV impacts one’s mental health.
  • Nurses take care of you at appointments and give immunizations. They educate patients and are the point of contact between you and your doctor.

It’s important to remember that HIV is a serious condition, and it’s always okay to ask to talk with a physician. Everyone is here to help you. 💗

Is there something else I can get beyond primary care?

Two other main things an HIV clinic can offer are PrEP and PEP, which are for people that don’t have HIV.

PrEP stands for Pre-Exposure Prophylaxis. The ‘pre’ there means ‘before’, because that’s how you’re meant to use PrEP. It’s available in a daily pill or a shot you get every 2 months. If you use it consistently, the risk of HIV infection is reduced by over 99%! 😲 Keep in mind that PrEP doesn’t protect against other sexually transmitted infections. (Luckily, there are great prevention methods out there for other STIs- read this article to find out more!)

PEP stands for Post-Exposure Prophylaxis, used when someone might have been exposed to HIV. 💊 PEP must be started within 72 hours after the possible exposure. It’s taken for about a month, and it dramatically reduces the chance of getting HIV.

What about community support?

Most HIV clinics have great support networks. Be sure to ask for more information at your HIV clinic. The kinds of communities you can find vary from intense support groups to casual get togethers, but all help remind you that you’re not alone. For example, MetroHealth Medical Center has amazing options for patients and residents of Northeast Ohio!

You can also sign up to the Positive Peers app, which offers an awesome support system, no matter where you are. Our team at MetroHealth sees the Positive Peers app as an extension of the support network patients have available through our HIV clinic.

Download the app by tapping the link above, and you can always reach out to us for support with signing up.

And that’s it! Hopefully that answers most of your questions about HIV clinics and makes you feel ready to take that next step. You’ve got this!