x x x
x
HIV Specialist for consideration of beginning HAART while a definitive diagnosis is pending. Adolescents must receive disclosure of their positive HIV status in a supportive environment. An expedited algorithm for discordant HIV test results in pregnant women must be followed, as above. Pregnant women who initially test HIV negative at ante-natal care registration should be retested either at 36 weeks gestation or at onset of labor, whichever comes first, in order to detect intercurrent HIV infection during pregnancy. Clinicians must be alert to the signs and symptoms of the acute retroviral syndrome in a patient of unknown HIV status, especially if there has been recent high-risk exposure. Although acute HIV infection is not, in and of itself, an indication for HAART initiation in Botswana, a patient with severe symptoms of the acute retroviral syndrome should be discussed with an HIV Specialist for possible HAART initiation.
25