STD Toolkit

Human Immunodeficiency Virus (HIV)


Primary Infection:
  • Flu-like illness: fever/chills, headache, muscle aches
  • Rash
  • Swollen lymph nodes
  • Sore throat
  • Mouth and/or genital ulcers
  • Joint pain
  • Night sweats
  • Diarrhea
Latent Infection:
  • Swollen lymph nodes
  • Asymptomatic
Progression to AIDS:
  • Weight loss
  • Fever
  • Night sweats
  • Fatigue
  • Swollen lymph nodes
  • Diarrhea
  • Lesions in mouth
  • Pneumonia
  • May have symptoms of any opportunistic infection

Definitive Diagnosis:

A positive EIA with confirmatory Western Blot, Multispot, IFA, or HIV-1 RNA assay.

Routine HIV screening should be done for:

  • Anyone who seeks STD testing
  • All patients age 13-64, especially:
    • Pregnant women
    • High risk individuals (multiple partners, MSM, commercial sex, unprotected sex, injection drug users, blood recipients between 1978 to 1985)
  • Enzyme Immunoassay (EIA) - specimen can be whole blood, serum, plasma, dried blood spots, or oral fluid. 4th generation antigen/antibody combination EIAs are recommended.
  • HIV-1/HIV-2 Differentiation Assay (Multispot) - specimen can be serum or plasma. A reactive EIA specimen should be followed by a Multispot.
Recommended, with reservations:
  • Western Blot - specimen can be whole blood, serum, plasma, dried blood spots, or oral fluid. A reactive EIA specimen should be followed by a Western Blot or Multispot depending on the specimen type.
  • HIV Plasma RNA - specimen is plasma only. May be used as a confirmatory test or to identify acute infection in individuals that test negative for HIV antibodies.
Not Recommended:
  • Indirect Immunofluorescence Assay (IFA) - specimen is serum only. Used when Western Blot is unreadable or indeterminate.

Test kits are available through referral laboratories. Testing/test kit availability may vary by laboratory.

Click here for more information on the tests.

*Note (If not using the recommended (green) tests): Many of the available recommended tests now detect HIV-1 (including uncommon variants) and HIV-2. If HIV is suspected but a test is negative or a patient has epidemiologic risk factors for HIV-2, verify that the test you are using encompasses all strains. Clients being tested for HIV should receive counseling, especially if they test positive. Counseling for individuals with a positive test may be done by referral to another organization if it can be ensured that the referral will be successful.

Refer immediately to a HIV clinical care provider.

PrEP is recommended as an HIV prevention option for adults that are at high risk of infection. HIV infection status should be determined at initiation of treatment and every three months while treatment continues; PrEP should not be taken by HIV positive individuals.

Dosage: Tenofovir disoproxil fumarate (TDF) 300 mg and emtricitabine (FTC) 200 mg (Truvada) once daily

For more information on prescribing PrEP, see Preexposure Prophylaxis for the Prevention of HIV Infection in the United States - 2014: A Clinical Practice Guideline

Click here for a directory of Michigan health care providers who prescribe PrEP.

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Generalized HIV Rash
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Secondary Aphthous Stomatitis Infection
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Kaposi's Sarcoma of the Hard Palate