What Do I Do If The Test Is Positive?

The moments after learning you’re HIV-positive can seem like a virtual free-fall. In a matter of seconds, you are sent into a tailspin of what-if scenarios and your vision is filled with horrific images from a bad movie montage. Your mind races, then stalls completely, working in frantic fits and spurts and grasping onto the few nuggets of information you can remember about what it means to be HIV-positive today.

The nurse tells you that you are going to be just fine and that HIV is now a manageable disease. The doctor tells you that if you take care of yourself, you can expect to live the same length of time as you would have if you didn’t have HIV.

Even with the reassurance, there's an inescapable fear of the unknown. What does it mean to live with HIV? What's going to have to change in your life, and more importantly, what can you expect to remain the same?

You aren’t alone. There are so many others who have gone through the exact same thing and have already asked all the same burning questions that you now need answers to. Below are some quick answers to those top questions.

What do I do now?

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The first thing to do is to stop panicking. You are the same person who walked into the clinic before receiving your test results. It may seem like everything has changed, but it hasn’t. Still, there are some things you can do to ease your mind and find your way back to being OK.

Do I need a different doctor?

You do need to find a doctor who is highly knowledgeable about HIV and one who is the right fit for you. You might be surprised about how unknowledgeable your average family doctor is about HIV and how best to treat it. The last thing you need is to be treated by a doctor who has just as many questions as you have. There are many HIV specialists, usually they are called infectious disease specialists, who know exactly how to treat you, how to ease your concerns, and which of the hundreds of different treatment combinations are best for you. These doctors can also act as your primary care physician, and keep your HIV treatment in mind when minor health issues arise along the way.

What happens at my first doctor’s appointment?

During your first appointment, your doctor will draw blood to do your initial lab work. This is to see what your CD4 count and viral load are. Your CD4 count is the number of disease-fighting white blood cells you have in your body and your viral load is the number of copies of HIV that are in your blood. So you want your CD4 to be high and your viral load to be low (and eventually, hopefully, undetectable).

This sounds scary, but it doesn’t have to be. No matter what your CD4 count may be, many newly-diagnosed people can bring their count up by simply taking a single-pill regimen. The same medication can also reduce your viral load to an undetectable level, making it highly improbable for you to transmit the virus to someone else. Your doctor will also determine whether the virus strain you have is resistant to any specific medications, which happens but is unlikely. 

Most likely, this will be the extent of managing your virus, along with regular checkups with your doctor to make sure that your body is healthy and that your medication is working. The key to staying healthy and keeping an undetectable viral load is to never miss a dose — just as you should with medication you’re prescribed for other ailment.

Can I only have sex with other people who are also HIV-positive?

Of course not! Today, there are multiple ways to have safer sex, and believe it or not, most men are knowledgeable enough to know that informed sex is the safest sex of all, regardless of HIV status. Condoms, PreP (for you partner), and treatment as prevention can all help keep everyone safe. Again, staying compliant with your meds and maintaining an undetectable viral load is the best way to ensure that you never transmit the virus to a sexual partner. This method of prevention is for your protection just as much as it is for your partner — and the bonus is, it helps you stay healthy.

How will I tell my friends and family?

First off, you don’t have to tell anyone except your recent past and future sexual partners. But talking about your status may be the best way for you to feel like yourself again. There are probably other people around you who are either HIV-positive or have been affected by HIV in one way or another. The first time you tell someone may be scary, but it gets easier every time. The first step is to just say the three little letters out loud. Start there.

What does it mean to manage my virus?

For most people who are diagnosed today, managing your virus simply means being compliant with a one-pill-a-day regimen. Once you find a doctor, start medication, and achieve an undetectable viral load, you will just need to have your lab work done every four months or so to make sure that everything is all right.  

Am I going to die?

Here’s the deal. A person diagnosed today has roughly the same life expectancy as a person who is HIV-negative. However, your virus does make you more susceptible to several other health problems that you need to be aware of. Some of these are cardiovascular disease, kidney problems, and bone density loss. But before you start to panic again, know that these can be prevented with the proper care. Being knowledgeable about what to look out for is the best way to ensure a long and healthy life.

Am I going to get AIDS?

The term AIDS does seem scarier than HIV, doesn’t it? The truth is, many people who are living with HIV will never be diagnosed with AIDS. HIV is a virus; AIDS is a diagnosis that a person receives once the virus reaches a certain point (many healthcare workers now call it HIV 3, because that’s the stage of the virus). When your CD4 count dips below 200 and your immune system is so damaged that common illnesses can be life-threatening, your disease is classified as AIDS. For many who are just diagnosed, if you stay on your medication and keep a healthy body and mind, you can keep your CD4 count in the healthy zone and far away from the level of AIDS. And if your CD4 count is already in the danger zone, the correct medication can bring you back up to healthy levels.

Just remember: Even if the test is positive, your diagnosis is not the end of anything. It may be the beginning of living a more informed and health