Test or Intervention 2013 IDSA Guidelines 2009 IDSA Guidelines
Viral load Perform every 3-4 months; perform every 6-12 months if clinically and immunologically stable for 2-3 years Perform every 3-4 months
CD4 cell count Perform every 3-4 months; perform every 6-12 months if clinically and immunologically stable for 2-3 years Perform every 3-4 months
Fasting glucose and/or HbA1C Perform every 6-12 months in all patients; consider HbA1C 5.8% as cutoff for diabetes mellitus Perform fasting glucose every 6 months
Fasting lipid profile No change from 2009 recommendations Perform every 6-12 months; consider performing 1-3 months after starting or modifying treatment; follow NCEP guidelines*
Bone Densitometry Perform baseline exam in postmenopausal women and men age  ≥ 50; periodic monitoring thereafter Perform baseline exam in postmenopausal women aged ≥ 65 years and in younger postmenopausal women with 1 or more other risk factor(s) for premature bone loss; consider in persons aged ≥50 years, especially if they have ≥1 risk factor(s) for premature bone loss; periodic monitoring thereafter
Pneumococcal vaccine Patients should receive a dose of PCV13 (Prevnar 13), followed by a dose of PPV23 (Pneumovax) at least 8 weeks later.  If previously vaccinated with PPV23, give PCV13 at least 1 year after PPV23; administer to patients with CD4 cell count ≥200 cells/μL. A second PPV23 dose is recommended 5 years after the first PPV23 dose Patients should receive PPV23; administer to patients with CD4 cell count >200 cells/uL; consider booster dose 5 years after initial immunization
HPV vaccine Indicated for females age 9–26 and males age 9–26 Indicated for females aged 9–26 years but may consider in other groups
Anal Pap test Anal Pap test should be performed in MSM, women with a history of receptive anal intercourse or abnormal cervical Pap test results, and all HIV-infected persons with genital warts Consider if indicated
Trichomoniasis screening Perform annually in all women; repeat testing 3 months later if positive Screen at initial visit followed by periodic screening in high-risk groups
Gonorrhea and chlamydia screening Perform annually in patients at risk for STDs; more frequent testing may be indicated in patients at high risk for STDs; repeat testing 3 months later if positive Perform annually in patients at risk for STDs;more frequent testing may be indicated in patients at high risk for STDs
Table 1: Summary of Major Changes in the 2013 IDSA HIV Primary Care Guidelines.
*New American College of Cardiology/American Heart Associationlipid management guidelines were published in November 2013 replacing NCEP guidelines.