This article previously appeared in The Positive Side, a publication of CATIE, here.
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People with HIV are living longer and better than ever before. But, unfortunately, they are also more likely to develop a host of health conditions—thinner bones, heart disease, arthritis, diabetes, even cancer. Thankfully, there are screening tests that can help flag a problem early on and potentially even save a life.
If you’re HIV positive, chances are that you already see a GP or HIV specialist who tracks your viral load and CD4 counts. If you’re over 50, your doctor may also recommend some of the following tests to help you stay ahead of the curve:
Bone density scan
Both aging and HIV can cause our bones to eventually become less dense. Some anti-HIV drugs (notably, tenofovir [Viread, also in Truvada, Atripla, Stribild and Complera]) can also cause a loss of bone density. If you are a post-menopausal woman or a man over 50, speak to your doctor about getting a bone density scan to establish your baseline. After that, your doctor can advise you about how often you will need one to measure the density of your bones.
A blood-pressure monitor measures the force of blood against the walls of your arteries and can help indicate your risk of developing heart disease.
Blood glucose test
This blood test measures your blood sugar level and your risk for diabetes. It is recommended that you have one every three to six months.
Kidney function tests
Because kidney function declines with age and certain HIV drugs (such as tenofovir, atazanavir [Reyataz] and indinavir [Crixivan]) are processed by the kidneys, doctors often recommend that you periodically have blood and urine tests to check your kidney function.
People with abnormal lipid levels (sometimes called “high cholesterol”) are at higher risk for heart disease. Simple blood tests can measure your lipid levels: LDL (“bad” cholesterol), HDL (“good” cholesterol) and triglycerides. Your doctor will recommend that you have these tests once a year or more, depending on your previous measurements and other risk factors for heart disease.
Tests to screen for colorectal cancer
A few tests can detect cancer of the colon and rectum. These include a stool test, a digital rectal exam (where a doctor inserts a gloved finger into the rectum to feel for abnormalities) or a scope inserted into the rectum. Your doctor will let you know how often you should be screened.
Anal pap test
Many HIV-positive people have HPV (human papilloma virus), which can cause anal cancer. To prevent this, speak to your doctor about a clinic in your region that provides screening for anal cancer.
If you’re a woman (cis or trans) or a trans man…
To detect possible early signs of breast cancer, your doctor will check for lumps or other abnormalities in your breasts and armpits. It is recommended that you have a breast exam once a year.
A mammogram uses a low-dose X-ray to look for different types of tumours and cysts in the breasts. Speak to your doctor about how often you should have this test.
A doctor collects cells from the cervix, which are then examined under a microscope. A Pap test is used to look for cell changes that indicate the presence of cancer or changes that could lead to cancer. You should have a Pap test every year if you're HIV positive and sexually active.
A pelvic exam is a physical exam of the internal and external pelvic organs. It is usually combined with a Pap test every year.
If you’re a man or trans woman…
It is recommended that you have a manual digital exam once a year after the age of 40. Your doctor may also order a PSA blood test, which screens for prostate cancer. (PSA screening tests are free in most but not all parts of the country. Check with your doctor to find out if you are eligible for one.)
If this checklist looks daunting, you’ll be relieved to know that most of these tests are simple and cause little or no discomfort. For more information about screening tests and what to expect, talk to your healthcare provider or contact CATIE at 1.800.263.16381.800.263.1638 or