Just diagnosed with HIV — your first 90 days, plainly.

If you found out today, you are probably not reading this calmly. You may have read the same sentence four times. That is normal, and it passes. So before anything else: you are going to be okay. Not in a vague, motivational-poster way — okay in the specific, measurable, boring-medical-fact way. HIV is treated with one pill a day for most people. Treatment works. Federal treatment guidelines say you can start medication at your very first care visit, sometimes the same day you get your result.1

This page is written for the first 90 days. Not the philosophy of living with HIV, not the politics, not the long view — just what happens next, in order, with the sources so you can check every claim yourself. Read the first two sections tonight and close the tab. The rest will still be here tomorrow.

First things — what this diagnosis actually means in 2026

Here is the whole medical situation in four sentences. HIV is a virus that, untreated, damages the immune system over years. Treated, it is suppressed to the point that standard lab tests cannot detect it in your blood. Suppression protects your immune system, keeps you healthy, and stops you from passing HIV to sexual partners. The medication that does this is usually a single tablet taken once a day.

The National Institutes of Health puts it plainly for people who have just tested positive: although an HIV diagnosis might seem overwhelming, HIV can be treated effectively with HIV medicines, allowing people with HIV to live long, healthy lives — and the first step is to see a health care provider even if you do not feel sick.5

Life expectancy: the number you are actually looking for

You almost certainly typed something into a search bar tonight that you regret. So let's answer the real question with real data. A large multi-cohort study published in The Lancet HIV in 2023, pooling data from Europe and North America, found that for people with HIV on antiretroviral therapy with high CD4 cell counts who survived to 2015 or started treatment after 2015, life expectancy was only a few years lower than that of the general population — regardless of when treatment was started.8 In the same analysis, a 20-year-old starting treatment with a CD4 count of 500 or above had an estimated life expectancy of 74.5 years in the 2008–2011 period and 77.4 years in 2011–2016.8

The same study is honest about the flip side, and it is the reason this page exists: for people who entered follow-up with low CD4 counts, life-expectancy estimates were substantially lower, which the authors say emphasizes the continuing importance of early diagnosis and sustained treatment.8 Translated: the thing that determines your next fifty years is not that you have HIV. It is whether you start treatment and stay in care. You are holding that variable right now.

HIV is not AIDS, and a positive test is not a stage

A reactive or positive HIV test tells you the virus is present. It does not tell you your immune status, your stage, or your prognosis. That comes from two lab numbers you will get shortly — your CD4 count (how many infection-fighting immune cells you have) and your viral load (how much virus is in your blood).5 Treatment prevents HIV from destroying CD4 cells and drives viral load down toward undetectable.5 Most people diagnosed today never develop advanced HIV disease at all, because they start medication long before that point.

What you do not have to do tonight

You do not have to tell anyone. You do not have to decide who to tell. You do not have to reconstruct your sexual history, assign blame, or figure out when you acquired HIV — none of those change your treatment. You do not have to quit anything, throw anything out, or move out of your home. You do not have to become an expert. You have exactly one job in the next few days: get an appointment.

Hour 0 to hour 24 — breathe, and do not isolate

The first day is a physical experience as much as an emotional one. People report shaking, nausea, going numb, or feeling strangely fine and then falling apart six hours later. There is no correct reaction. What matters in these hours is not processing the news well; it is not being alone with it and not making irreversible decisions.

Call one person — one

Not five. One. The goal is to break the isolation, not to run a disclosure campaign while you are in shock. Pick the person who is calmest and least likely to make it about themselves. If nobody in your life fits that description tonight, pick a stranger whose job it is — that is not a downgrade, it is often better.

The 988 Suicide & Crisis Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress, 24 hours a day, 7 days a week, across the United States and its territories, through a national network of more than 200 local crisis centers.14 You do not have to be suicidal to call, text, or chat 988 — the service is explicitly for emotional distress as well.14 If tonight is bad, that is the number.

If what you want is another person living with HIV rather than a crisis counselor, the POZ Community Forums run around the clock and include boards specifically for people who have just tested positive, alongside boards for living with HIV, mental health, insurance and benefits, and long-term survivors.16 POZ's own guidance for people newly diagnosed starts with the same instruction this page does: take a deep breath, and know that with proper care you can live a long and healthy life.16

Three things worth writing down before you sleep

• Where you tested and who told you. The clinic, health department, or provider that gave you the result is also your fastest route into care — most testing sites have a linkage-to-care worker whose entire job is booking your first appointment. Get that name and number before you leave, or call back tomorrow.
• Whether you were given medication or a prescription today. Some clinics hand you a starter supply on the spot. If yours did, that is a good sign, not an alarming one.
• One question you want answered. Write it on your phone. Tomorrow, in a room with a clinician, you will forget it otherwise.

Week 1 — getting into HIV care

Your entire goal for week one is a first appointment with someone who treats HIV regularly. That can be an infectious disease physician, an HIV primary care provider, a nurse practitioner or physician assistant in an HIV clinic, or a Ryan White–funded clinic. Volume matters more than title: you want someone who does this every week, not someone encountering their second case.

Where to look, in order of speed

• The site that tested you. Health departments and community testing programs are usually wired directly into local HIV clinics and can often get you seen within days.
• A Ryan White–funded clinic. The Health Resources and Services Administration's Ryan White HIV/AIDS Program provides medical care, medications, and support services for people with low incomes and inadequate or no insurance — and each year more than half of all people diagnosed with HIV in the United States, over 600,000 people, receive services through it.9
• An HRSA-funded health center. Federally funded community health centers charge on a sliding scale based on income and treat people regardless of insurance status.
• A hospital infectious disease clinic. Slower to schedule, but the guidelines are clear that if you are hospitalized for any reason, treatment should be started during that hospitalization.1

What to say on the phone

You do not have to explain yourself. "I received a positive HIV test result and I need a new-patient appointment for HIV care. What is your soonest opening, and do you do same-day or rapid medication starts?" That last clause is the one that gets you moved up, because clinics that run rapid-start programs have protocols and slots specifically for new diagnoses.

If the first number gives you a six-week wait, call the second and third, and ask whether they can see you as a walk-in. A long wait at one clinic is a statement about that clinic's schedule, not about your options.

If you have no insurance and no money this week

You still get care this week. That is not aspirational — it is how the safety net is built, and section six of this page walks through it in detail. The short version: the Ryan White program exists precisely for people who are uninsured or underinsured, the drug manufacturers run assistance programs that can supply medication at no cost, and neither one requires you to have money today.911

Same-day and rapid ART — why they may hand you pills at your first visit

If a clinician offers you medication at your first appointment, before your labs are back, that is not carelessness. It is the current federal standard of care.

The Department of Health and Human Services panel that writes the U.S. adult and adolescent antiretroviral guidelines states that it recommends initiating ART at the time of diagnosis (when possible) or soon afterwards to increase treatment uptake, decrease the time needed to link to care and reach viral suppression, and improve the rate of viral suppression — rated AII, meaning a strong recommendation supported by well-designed non-randomized trial or cohort data.1 The same guidelines say ART should be initiated as soon as possible after HIV diagnosis, and that same-day or rapid initiation has been shown to be safe, acceptable, and effective.1

You do not wait for resistance testing

Older practice was to draw a resistance genotype, wait one to two weeks for the result, then choose a regimen. Current guidelines reverse the order: send the genotype, start treatment, adjust later if the result requires it. The guidelines state that before starting ART, and without delaying its initiation, a blood sample should be sent for genotypic resistance testing,1 and that treatment can be initiated before drug-resistance test results are available.1 New York State's HIV clinical guidelines program says the same thing about labs generally: when initiating ART at the time of HIV diagnosis, it is not necessary to have baseline laboratory results immediately available.4 HIV.gov tells people directly that you may start treatment, or be referred for treatment, before your test results are in.3

What you will probably be prescribed

For most people starting treatment, the guidelines recommend an integrase inhibitor–based regimen. Bictegravir/tenofovir alafenamide/emtricitabine — sold as Biktarvy, a single daily tablet — is listed as recommended for most people with HIV, rated AI (strong recommendation, randomized trial data), as is dolutegravir combined with tenofovir plus emtricitabine or lamivudine.2

For rapid starts specifically, the guidelines narrow the field for safety reasons. In the rapid-start scenario, with no prior exposure to long-acting cabotegravir, the recommended options are bictegravir/tenofovir alafenamide/emtricitabine or dolutegravir plus tenofovir with emtricitabine or lamivudine — while abacavir-containing regimens, the two-drug combination dolutegravir/lamivudine, and NNRTI-based regimens are avoided.2 The reasoning is practical: abacavir requires a negative HLA-B*5701 test result first,4 and the two-drug regimen is not appropriate before hepatitis B and viral load results are known.2

You do not need to memorize any of this. It is here so that when a clinician says "we'll start you on Biktarvy today," you know that is a guideline-concordant choice and not an experiment.

"Ready" means ready enough

Rapid start is offered when a person is ready to begin — not when they have processed the diagnosis, forgiven anyone, or achieved peace. Ready means you understand what the medication does, you are willing to take it daily, and you have a plan for the next refill. If you are not there on day one, that is legitimate; the recommendation is "as soon as possible," not "or never."

Your first labs — what they are drawing and why

Your first visit involves a review of your health and medical history, a physical exam, and several lab tests, and the information collected is used to make decisions about treatment.5 It is a lot of tubes. Here is what is in them.

The DHHS guidelines' entry-into-care panel includes: CD4 count, HIV viral load, genotypic resistance testing (protease and reverse transcriptase, with integrase testing in some situations), hepatitis B serology, hepatitis C screening, a basic metabolic panel, ALT/AST and total bilirubin, a complete blood count with differential, a lipid profile, a random or fasting glucose, urinalysis, and a pregnancy test where applicable. HLA-B*5701 is checked only if abacavir is being considered.3

The two numbers people fixate on

Viral load measures how much virus is in your blood. It is the number that tells you whether treatment is working, and it is the one that will drop. CD4 count measures immune cells and tells you how much damage has already happened. Once treatment is started, both are used to monitor whether the medication is controlling HIV.5

Two things about the CD4 number. First, it recovers — slowly, but it recovers. Second, it is not a scoreboard and it fluctuates for reasons unrelated to HIV, including recent illness and time of day. If your first CD4 is lower than you hoped, that is information about the past, not a prediction.

The monitoring schedule

• Viral load 4 to 8 weeks after starting treatment, then every 4 to 8 weeks until it is below 50 copies/mL, then every 3 to 6 months.3
• CD4 repeated at 3 months if your pre-treatment count was below 300.3
• You will not repeat everything. The guidelines note that if ART is initiated soon after diagnosis and entry into care, repeat baseline laboratory testing is not necessary.3

New York State's guidance for rapid starts adds a practical touch worth asking your clinic about: a follow-up contact within two weeks of starting, and a viral load within four weeks.4 If nobody has called you in two weeks, call them.

For a slower walk through each test, what the ranges mean, and how to read your own results portal without panicking, see Understanding Your Labs.

Insurance and money in the first month

This is the section people are most afraid of and the one where the news is best. The United States built a specific safety net for HIV care, and it does not require you to have insurance, savings, or documentation of a good month.

Ryan White — the backstop

The Ryan White HIV/AIDS Program is federally funded through HRSA and provides medical care, medications, and support services to people with HIV who have low incomes.9 It is organized in parts: Part A funds care in the hardest-hit metropolitan areas, Part B funds states and territories and includes the AIDS Drug Assistance Program (ADAP) that pays for medication, Part C funds community-based outpatient care, Part D funds care for women, infants, children, and youth, and Part F funds clinician training, dental care, innovation projects, and the Minority AIDS Initiative.9

Ryan White is legally the payer of last resort, which means eligibility is based on HIV status, low income, and residency, and the program pays after other coverage is exhausted rather than instead of it.9 In practice, a case manager at a Ryan White clinic will help you enroll in whatever you actually qualify for — Medicaid, marketplace coverage, ADAP — and Ryan White covers the gaps.

Does it work? HRSA reported that in 2024, a record 91.4% of people receiving HIV medical care through the Ryan White program were virally suppressed — up from 69.5% in 2010, and well above the 67.2% national rate among all people with diagnosed HIV.10 If you are worried that "free clinic" means "worse care," that number is the answer.

Medication assistance from manufacturers

Separately from Ryan White, the companies that make HIV medications run patient assistance programs. HIV.gov maintains a resource listing these programs and their income thresholds, which are generally set as a percentage of the federal poverty level — around 500% for the Gilead and ViiV programs, 400% for Merck, and 300% for Janssen.11 Those are unusually generous ceilings; many people who assume they earn too much to qualify actually do.

• Gilead Advancing Access. Gilead's patient assistance program provides its HIV medications, including Biktarvy, at no cost to eligible people who are uninsured and reside in the United States, Puerto Rico, or U.S. territories, with enrollment for up to 12 months. Enrolling online can produce an immediate eligibility decision; faxed forms are reviewed within two business days. The support line is 1-800-226-2056.12
• ViiV Healthcare's patient assistance program, through ViiVConnect. ViiV's program offers its HIV medicines at no cost to qualifying people and is administered by the GSK Patient Access Programs Foundation; the line is 1-844-588-3288, Monday through Friday, 8 a.m. to 8 p.m. Eastern.13 ViiV's clinician-facing materials also describe a presumptive fill at no cost for people without insurance who need urgent access — worth naming out loud if your pharmacy hits a wall.13
• Copay programs. If you have commercial insurance, manufacturer copay assistance can reduce your out-of-pocket cost to as little as $0 per month. These programs are not available to people on Medicare or Medicaid, who are routed to Ryan White and ADAP instead.12

The order of operations

Ask the clinic for a case manager or benefits navigator at your first visit — before you try to solve insurance yourself. That person does this daily, knows which local programs have open slots, and can usually get medication in your hands while the paperwork is still moving. If you lost job-based coverage recently, or your income changed, ask them specifically about a marketplace special enrollment period and about Medicaid, which enrolls year-round rather than in an annual window.11

One sentence to keep: the guidelines themselves acknowledge that lack of insurance or an inability to pay can make it hard to take HIV medicines consistently, and instruct providers to connect people with resources before starting a regimen.5 Bringing up money is not a confession. It is part of the protocol.

Whom to tell, and when — you set the pace

Disclosure is not one decision. It is dozens of small ones, spread over years, and almost none of them are due this week.

Four different questions people collapse into one

• Current and recent sexual partners. This is a health question — they may benefit from testing, and there are ways to handle it that do not require you to have the conversation yourself. See the partner notification section below.
• A committed partner or spouse. This is a relationship question and usually the hardest one. It is also the one where U=U changes the conversation most, so it may be worth waiting until you understand your own treatment before having it.
• Family and friends. This is entirely discretionary and there is no health reason to rush. Many people living with HIV tell one or two people in year one and more later, or never expand the circle. Both are fine.
• Employers and coworkers. Almost never medically necessary. Your HIV status is protected health information.

Practical guardrails

Tell someone when you have decided what you want from them, not when you are most desperate — disclosure in crisis hands the other person your emotional regulation, and they are rarely equipped for it. One at a time. Expect that some reactions will be about their own fear, and that the person you expected to handle it worst may handle it best.

There is a fuller treatment of scripts, timing, workplace questions, and how to handle a bad reaction in Stigma & Disclosure.

U=U — the thing that changes how this feels

Somewhere in the first month, usually when you get a viral load result, this stops being an abstraction. Undetectable equals untransmittable, and it is not a slogan — it is in the federal guidelines with a strength rating.

The DHHS guidelines state that all people with HIV should be informed that maintaining a plasma viral load below 200 copies/mL prevents sexual transmission of HIV, and that this concept may be recognized as Undetectable = Untransmittable, or U=U — rated AII.6

The studies behind it

CDC summarizes the evidence base as three landmark studies showing that treatment prevents sexual transmission of HIV.7 HPTN 052 followed more than 1,600 mixed-status heterosexual couples over a decade; NIAID describes early and sustained treatment as having essentially eliminated transmission in that trial, and the final 2016 results reported no transmissions within couples while the partner living with HIV had a suppressed viral load.7 The PARTNER studies then followed couples having condomless sex, and reported a transmission rate of 0.00 per 100 couple-years for any sex, with a 95% confidence interval upper bound of 0.30 — and 0.00 (upper bound 0.89) for anal sex among male couples.7 Zero, not "very low." CDC's clinical guidance for providers states there is no chance of sexual transmission when viral load is suppressed, and for pregnancy, labor, and delivery the risk is 1% or less.7

How long until you get there

NIAID states that for almost everyone who starts taking HIV medication as prescribed, viral load will drop to an undetectable level in six months or less.15 NIH's treatment information puts the usual range at three to six months.5 "Durably undetectable" means undetectable for at least six months.15

In the interim, the guidelines advise using another prevention method with partners for at least the first six months of treatment and until a viral load below 200 copies/mL has been documented.6 That is a short bridge, not a permanent condition.

What U=U means in practice: you can have sex, you can be in a mixed-status relationship, you can conceive and carry a pregnancy, and you are not a danger to the people you love. If you want the full evidence walkthrough, see Undetectable = Untransmittable.

Mental health in the first month

If you feel worse psychologically at week three than you did on day one, you are not deteriorating. You are on schedule.

A study of people diagnosed during acute HIV infection, published in AIDS and Behavior, found that at diagnosis 55.0% reported symptoms exceeding published thresholds for depression and 65.8% met criteria for clinically relevant anxiety.17 Those are majority figures, not fringe ones. The same study found substantial reductions after starting combination antiretroviral therapy: by 24 weeks, 17.1% still met the anxiety threshold and 8.1% to 17.9% met depression thresholds depending on the measure used.17

Read those two sentences together, because the sequence is the point. Distress at diagnosis is close to universal, and it improves — measurably, for most people, within months, alongside treatment.

What to actually do about it

• Ask your HIV clinic what mental health services they have in-house. Many Ryan White–funded clinics provide behavioral health on site, and Part F of the program funds services beyond basic medical care.9 Integrated care means one intake, one building, and a therapist who already knows what an HIV diagnosis is.
• Say it out loud at the first visit. "I am not sleeping" and "I have not eaten since Tuesday" are clinically relevant and will change what your provider does.
• 988 for the acute hours. Free, confidential, 24/7, by call, text, or chat.14
• Watch for the specific shapes this takes. Rumination about how you acquired HIV. Anticipatory dread about disclosure. A compulsion to research. Sudden hypervigilance about your body. These are common and they respond to treatment.

A fuller guide, including how to find an HIV-literate therapist and what to do if your clinic has no behavioral health, is at Mental Health & HIV.

"So, I made plans to live with the virus, not die of it." — Lora René Tucker, writing in POZ about the anniversary of her diagnosis, twenty years on

Partner notification — three ways, and you pick

Letting recent sexual partners know they may want to test is a real thing to handle, and the reason it feels enormous is that most people assume there is only one way to do it. There are three, and two of them do not involve you having the conversation.

1. Health department partner services

Public health departments employ disease intervention specialists who will notify partners for you, free of charge. In the provider-referral model, you give the health department partner information and they make contact without identifying you — your anonymity is maintained. Self-referral means you tell partners yourself; dual referral means you and the specialist do it together.7 Ask about partner services at your first clinic visit; the staff there work with the health department routinely.

2. Anonymous digital notification

TellYourPartner.org lets you anonymously text or email a partner to let them know they may have been exposed to an STI, including HIV, and to suggest they get tested. It is free, it stores no information, and it was built by Building Healthy Online Communities, a consortium of public health leaders and dating app operators.18 The National Coalition of STD Directors and CDC's National Prevention Information Network both list it as a partner notification resource.18

One caution: type the address carefully. The .org address is the public health tool described here. A similarly named commercial site at a different domain is unrelated.

3. Telling them yourself

Sometimes this is right — a current partner, someone you trust, someone you would want to hear it from you. If you go this route, keep it short and factual, lead with what you want them to do ("I'd get tested; here's a free site"), and do not manage their reaction in real time. You are allowed to end the conversation and continue it later.

You are not obligated to notify anyone you cannot safely contact. If a partner has been violent or coercive, tell your clinician and let health department staff handle it. That is exactly what partner services are for.

The 30-60-90 day roadmap

Day 30 — is it working, and can you live with it

Your first on-treatment viral load is drawn 4 to 8 weeks after you start.3 Expect a large drop rather than a zero; a fall from hundreds of thousands to a few hundred copies is exactly what success looks like at this stage. New York State's rapid-start guidance suggests a follow-up contact within two weeks and a viral load within four.4

Also on the day-30 list: side effects. Modern integrase inhibitor regimens are generally well tolerated, but early nausea, headache, sleep disturbance, or vivid dreams do happen and often settle within a few weeks. Report them anyway — there are multiple recommended first-line regimens,2 and switching is normal. Do not quietly stop.

Day 60 — the logistics month

Month two is when the emergency ends and the administration begins. The things that quietly derail people at this point are boring: a prior authorization nobody followed up on, a pharmacy that does not stock your regimen, a Ryan White recertification, an assistance program enrollment that lapses at 12 months.12 Put your refill date in your calendar with a five-day lead. Get your case manager's direct line. Ask what happens if you lose your coverage.

It is also the month the acute shock wears off and what is underneath becomes visible. If you have not talked to anyone yet, day 60 is a reasonable deadline to set for yourself.

Day 90 — the review

By month three, viral load is repeated, and if your pre-treatment CD4 was below 300 your CD4 is repeated at three months as well.3 Once you are below 50 copies/mL, monitoring stretches out to every 3 to 6 months.3 Many people are undetectable by now; NIH's expected range is three to six months.5

Good questions for the day-90 visit: Am I on the right regimen long term? What vaccines am I missing? Do I need a hepatitis B vaccination based on my serology? What is my monitoring schedule from here? Who do I call when something goes wrong?

What not to do in the first 90 days

Do not stop taking your medication because you feel fine

This is the single most common and most costly mistake. Feeling fine is the medication working, not evidence that you did not need it. The guidelines' entire framework — start at diagnosis, monitor to suppression, maintain below 200 copies/mL — depends on continuous daily dosing.16 Adherence is a skill and a logistics problem, not a character test. If you are missing doses, say so plainly; providers can change the regimen, the timing, or the pharmacy.

Do not substitute supplements, cleanses, or "immune boosters" for treatment

Nothing sold online suppresses HIV. Tell your provider about anything you are taking, because some supplements interact with antiretrovirals — but do not let a supplement become the reason you delayed the one thing with randomized-trial evidence behind it.2

Do not read undated worst-case material

HIV information ages badly. Guidance from 2005 is a different medicine from guidance published in 2025. When you read something frightening, look for a date and a publisher before you let it in. If it does not have both, close it.

Do not try to disclose to everyone at once

Mass disclosure in the first weeks is usually a way of trying to make the shock stop by distributing it. It rarely works, and it cannot be undone. One person at a time, when you are steady, for a reason.

Do not ghost your own care

Missing the second appointment is more common than missing the first. If you no-show, call and rebook — clinics expect this and nobody is keeping score. What the life-expectancy data says actually matters is staying connected to care over time — and when people lose that connection, it is almost always because a structural barrier (insurance loss, housing instability, transportation, unaddressed mental health, work conflict) got in the way, not because they stopped caring.8

Peer support — talking to people who have been here

Clinicians give you information. Other people living with HIV give you the thing information cannot: proof that the future is habitable. Both are load-bearing.

• POZ Community Forums. An around-the-clock discussion space for people living with HIV and their friends, family, and caregivers, with dedicated boards including one for people who have just tested positive, plus boards on living with HIV, mental health, insurance and benefits programs, and long-term survivors.16 POZ also maintains a directory of HIV service organizations at directory.poz.com.16
• Positive Peers. A free mobile app for people living with HIV ages 13 to 34 in the United States, developed by the MetroHealth System, which originated with Ryan White Part F special projects funding.19 It has been studied: published research reports that younger users were more likely to achieve sustained viral suppression, and that use was associated with reduced perceived stigma.19
• Local HIV organizations. Many Ryan White–funded clinics and AIDS service organizations run newly diagnosed groups, peer navigation, and case management alongside medical care.9 Ask at your first appointment; peer navigators are often the most useful person in the building.
• Peer-led community media. Publications written by and for people living with HIV — POZ, Positively Aware, TheBody — are where the lived-experience side of this lives. Use them for voice and perspective; anchor the clinical questions to your provider and the federal guidelines.

One note on online support: it is unmoderated human beings. Take the solidarity, be skeptical of the medical advice, and never change your regimen based on a forum post.

Florida — where same-day treatment already exists

Florida has one of the longer-running rapid-start infrastructures in the country, and if you are reading this from anywhere in the state, same-day treatment is not a hypothetical you have to argue for.

The Florida Department of Health states that since 2016 Florida has had a rapid access to ART program called Test and Treat, which offers people newly diagnosed with HIV — and people returning to care — expedited practitioner visits, labs, and antiretroviral medication, combined with retention-in-care specialists. The department describes it as an expedited "red carpet" scenario in which people have immediate access to a provider who can start medication immediately, and lists same-day or rapid start within seven days as a statewide strategy.20

Miami-Dade: Test and Treat Rapid Access

Miami-Dade's Test and Treat Rapid Access program is designed so that an abbreviated first medical visit happens within three days of enrollment — preferably the same day, and no more than seven days — with antiretroviral therapy prescribed within three days and a resistance genotype ordered at initiation. Recommended 30-day starter regimens include bictegravir/emtricitabine/tenofovir alafenamide, and enrollment in ADAP or Ryan White Part A follows within 14 days.21 TargetHIV reports the model became standard of care for all Miami-Dade Ryan White Part A subrecipients, and that 2,821 people were linked and prescribed medication between July 2018 and June 2022.21 The peer-reviewed evaluation of the Miami pilot, run by the health department with the South Florida AIDS Network at Jackson Memorial and the University of Miami, reported 91.7% of participants virally suppressed below 200 copies/mL within 70 days and 97.2% suppressed at 12 months.21

Clinics that do this today

• Care Resource (Miami-Dade). Partnered with the health department on Test and Treat Rapid Access; the organization states that people without insurance or with inadequate coverage can also receive a 30-day supply of medication the same day. Intake line 305-576-1234, ext. 237.22
• Care Resource (Broward) — Test, Treat & Beat HIV. Launched with the Broward health department in 2017; ext. 158 on the same main line.22
• Florida Department of Health in Broward County. Describes immediate linkage to HIV primary care and initiation of antiretroviral therapy at the time of HIV diagnosis; 954-789-8139.22
• UHealth Rapid Access Wellness Clinic (University of Miami). Offers same-day enrollment into HIV care for new diagnoses and free confidential same-day testing, at no cost regardless of insurance or immigration status; 305-243-2584, with Allapattah and Miami Beach locations.22
• AIDS Healthcare Foundation. Runs walk-in HIV and STI testing with linkage into treatment, and operates its Positive Healthcare plan in Broward, Duval, and Miami-Dade counties.22
• North central Florida. The Florida Department of Health in Alachua County lists HIV clinic contacts for the Gainesville area, including UF Health Shands infectious diseases at 352-392-4058, alongside free confidential testing through UF's HealthStreet program.22

If you are outside these counties, the state plan's stated goal is statewide implementation of rapid start, and TargetHIV notes the health department has been working to extend the model to all Florida counties.2021 Call your county health department and use the words "test and treat." For a broader walkthrough of finding a clinic wherever you are, see Find Care.

What to do next — the short list

If you only act on one section of this page, act on this one.

1. Today. Tell one person, or call, text, or chat 988 if tonight is bad.14 Write down the name and number of whoever gave you your result.
2. Tomorrow. Call for an appointment and ask the words "do you do same-day or rapid ART starts?" Call three places if the first is slow.
3. At that appointment. Ask to start medication now — the guidelines recommend initiating treatment at diagnosis when possible, without waiting on labs.1 Ask to meet a case manager or benefits navigator the same day.
4. Within the first week. Get medication in hand. If cost is the obstacle, name it out loud and ask about Ryan White, ADAP, and the manufacturer assistance programs.911
5. Within the first month. Handle partner notification the way you choose — health department partner services, anonymous notification, or yourself.18 Get your first on-treatment viral load drawn at weeks 4 to 8.3
6. Within the first 90 days. Find one peer connection.16 Ask about mental health services.17 Review your care plan and your monitoring schedule.3

You will have a normal Tuesday again. Probably sooner than you think — most people describe the acute phase of this as weeks, not years, and the measured data on distress after diagnosis agrees with them.17 Go do the one phone call. The rest of it follows.