HIV-specific History Taking
- HIV Testing
- Treatment Status
- Obtains health care at
- Last HIV care visit
- current CD4, CD4 %, VL
- lowest CD4, first CD4 & VL
- pharmacy, PMD
- health care proxy
- Opportunistic Infections & HIV related illnesses
- Eyes: CMV retinitis (with loss of vision)
- Derm: HSV, Candidiasis, Histoplasmosis
- GI: candidiasis, isosporisis, CMV, cryptocococcosis, cryptosporidiosis, C difficile
- Resp: PCP, PNA, MAC, TB
- CNS: PML, Toxo, Lymphoma, HIV encephalopathy
- GU: cervical CA
- SKIN: MRSA
- General: salmonella, wasting syndrome, lymphoma, Kaposi
- STDs: syphilis, vaginitis, herpes, gonorrhea, chlamydia, genital warts (HPV), proctitis, PID, trichomonas
- HAART Therapy
- HIV medications taken in past
- When did you start & stop taking these medications?
- HIV & VL & CD4 counts while on the meds.
- When did you stop taking the meds? Why?
- Have you had resistance testing?
- Missed doses in past: 3 days, week, month
- HIV med side effects do you have now, or in past
- Sexual History
- General:
- sex w/men women or both
- Sexual partners (intercourse) in past 2 months, 12 months
- Are you in relationship?
- Sexual practices:
- anal, vaginal, oral sex.
- protection from STDs or HIV reinfection.
- how often do you use alcohol/drugs before or during sex?
- MSM: receptive, insertive partner or both
Risk Factors, Travel History
- Risk Factors
- Contacts: friends, hospital stays, incarceration
- Recent hospital procedure: surgical site infection, urinary catheter, IV lines
- Occupation:
- Food handlers i.e. handling raw food
- Animal exposure - farmers, vets etc
- leptospirosis
- cryptosporidiosis
- Sewage workers - leptospirosis, hepatitis A
- Healthcare workers
- viral gastroenteritis
- blood-borne viruses
- TB
- Pets - psittacosis, campylobacter
- Farm visits - psittacosis, campylobacter, cryptosporidiosis
- Blood borne viruses -
- HIV, Hepatitis B or C.
- IVDU
- Blood transfusions
- Tattoos & body-piercing
- Travel
- When, where, when they got back?
- Sexual contacts: HIV, Hepatitis B, STDs
- Food & drink:
- GI infections
- Enteric fever
- Hep A or E
- Accommodation including air conditioning - Legionnaire's
- Swimming in unchlorinated water:
- Schistosomiasis
- GI infections
- Precautions:
- vaccinations
- malaria prophylaxis
- mosquito net
Past Medical History, Family History
- Family History
- Heart disease? Heart attacks or strokes?
- Cholesterol problems? Diabetes?
- Cancer?
- Mental health conditions (e.g., depression, bipolar disorder, anxiety, phobias)
- Addictions?
- Previous Hospitalizations
- Hospitalizations? Where, when, reason?
- Surgeries? When and where?
- Major illnesses, including mental health
Health Risk Behaviors, Sexual History
- Health Risk Behaviors
- Sexual History
- General:
- sex w/men women or both
- Sexual partners (intercourse) in past 2 months, 12 months
- Are you in relationship?
- Sexual practices:
- anal, vaginal, oral sex.
- protection from STDs or HIV reinfection.
- how often do you use alcohol/drugs before or during sex?
- MSM: receptive, insertive partner or both
- HIV Prevention:
- measures to protect partners from HIV
- Condoms?
- Situations that you don’t use protection.
- Sex Trading: for food, shelter, drugs, or $$$?
