Outpatient medical settings may include clinics, medical offices, mobile vans, using telehealth technology, and urgent care facilities for HIV- related visits. Care must include access to antiretroviral and other drug therapies, including prophylaxis and treatment of opportunistic infections and combination antiretroviral therapies ART. Agencies will follow the Texas Medicaid policies to determine the appropriateness of contact lenses and contact lens-related appointments:. The standard also links to additional sources where applicable.
Clinical knowledge is continuously evolving, and providers will deliver care in accordance with the most recent available guidelines. Comprehensive HIV-related History: Providers will conduct a comprehensive health history that includes detailed HIV-related information and relevant medical, psychosocial, and family history.
Providers can complete this during the initial visit or divide it over two or three early visits. Providers will request and review medical records from previous treatment to supplement self-reported history and update the medical record accordingly. At a minimum, this health history will include:. Physical examination: Providers will perform a baseline and annual comprehensive physical examination, with attention to the areas potentially affected by HIV. Laboratory Tests: Providers will follow the most recent HHS guidelines, which contain detailed recommendations on laboratory tests for an initial assessment and treatment monitoring, including the appropriate testing intervals.
A licensed provider must order all tests. Screenings and Assessments: People living with HIV are at increased risk for developing cardiovascular disease, certain cancers, metabolic disorders, loss of bone mineral density, and neurocognitive disorders. Providers will conduct routine preventative health services, screening for opportunistic infections as applicable, and an assessment of psychosocial needs as appropriate.
For detailed information on screening modalities and timelines, refer to the United States Preventative Taskforce see source list. Providers will ensure clients receive all vaccinations with specific recommendations based on HIV status. The Advisory Committee on Immunization Practices ACIP recommends that in most circumstances, providers order vaccine doses for adults with unknown vaccine status except for influenza vaccines and pneumococcal polysaccharide vaccines.
