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Screening tests

While HIV is monitored using routine tests, additional tests may be required to monitor your health status as you get older.

Speak to your healthcare provider about which tests you should have and how often. Some common tests include:

  • Kidney function test: Kidney function declines with age, and certain HIV drugs are processed through the kidneys. For both of these reasons, a blood test (and sometimes a urine test) is recommended every six months on average.
  • Bone density scan: A scan of your lower spine and hip measures your bone density. It is recommended by most guidelines for all people living with HIV who are over 50 years old or who are post-menopausal.
  • Fasting blood glucose test or glycosylated hemoglobin (HbA1c) test: A blood test to screen for diabetes is usually done around the time of HIV diagnosis and then as clinically indicated (periodically after the age of 40, or earlier if there are other reasons to measure it).  
  • Lipid profile test: This blood test checks total cholesterol, LDL (bad fats), HDL (good fats) and triglycerides. It is recommended around the time of HIV diagnosis. After that, it may be recommended periodically based on your risk factors for heart disease, which may include use of gender-affirming hormone therapy.
  • Blood pressure monitoring: A blood pressure monitor measures the force of blood against the walls of your arteries. Your blood pressure is one of the factors that indicates your risk of developing heart disease.
  • Pelvic exam: A pelvic exam is a physical examination of the internal and external pelvic organs. It is usually combined with a Pap test.
  • Pap test: A Pap test collects cells from the cervix or anus for examination under a microscope. It is used to detect changes that indicate the presence of cancer, or changes that may lead to cancer.
    • People with a cervix who are sexually active and have HIV are recommended to have Pap tests every year to start. This frequency may be reduced if the first few tests are normal.
  • Anal Pap test: Routine anal pap tests are sometimes recommended for people living with HIV, especially gay men, bisexual men and other men who have sex with men.
  • Colorectal cancer screening: This is usually done either by a stool test or a scope (camera) inserted into the rectum and used to visualize the colon (colonoscopy or sigmoidoscopy).
  • Prostate cancer screening: A manual digital exam (using a finger) of the rectum and a PSA blood test can be considered to screen for prostate cancer, particularly for people over 50 years old or with other risk factors. However, there are benefits and risks to screening, so many people will choose not to undergo screening. Of note, a PSA blood test is not always covered by provincial insurance.
  • Breast cancer screening: A mammogram uses a low-dose X-ray to examine each breast. It is recommended every one or two years for anyone with breast tissue who is between 50-74 years old.