Skill Checkup: A 34-Year-Old Woman Newly Diagnosed With HIV

Michael Stuart Bronze, MD


June 01, 2023

The Skill Checkup series provides a quick, case-style interactive quiz highlighting key guidelines- and evidence-based information to inform clinical practice.

A 34-year-old woman presents to a general practitioner's office in Paris for a routine annual exam. She explains that she is new to the city, having moved recently from Marseille to live with her sister after separating from her husband of 5 years. Making this appointment was important to her as a step toward renewing a sense of her own wellness and establishing care with a clinician.

The nurse practitioner takes her vitals; all are normal. The patient mentions feeling anxious about being single and starting over in a new city but is grateful to have her sister's support. The nurse practitioner conducts an anxiety assessment along with other routine assessments. While discussing laboratory testing, the nurse practitioner recommends including HIV and hepatitis B virus (HBV) testing, explaining that, "HIV and HBV testing are routine tests if they haven't been conducted before and are a part of establishing wellness." The patient hasn't been tested before and agrees to screening for both.

When the test results return, HBV is negative, and HIV is positive. Viral load is approximately 80,000 copies/mL; CD4 count is 475 cells/mm3. The nurse practitioner invites the patient back to the office to share the results and discuss next steps.


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