The new guidelines will be announced next week by the San Francisco Department of Public Health. Patients are not being told "you have to take the antiviral drugs," but instead it is a strong recommendation.
Scott Wafrock is HIV positive but has never taken any antiviral drugs.
"I'm confident in my immune system's ability to take care of the virus that is there and get rid of it on its own," he said.
And for years, many doctors have waited to prescribe these drugs until there are signs the immune system is failing.
But San Francisco public health doctors will now urge patients to start treatment early after being diagnosed. The reason is that studies show the virus, even when very low, is causing permanent damage.
"So what we think is uncontrolled HIV virus replication is leading to damage not only to the immune system but increasing possibly your rate of things like heart disease, kidney disease and sudden neurological impairment that may be irreversible," Dr. Annie Luetkemeyer from UCSF division of HIV and AIDS said.
The new guidelines are controversial because once a patient starts taking the drugs he or she can't stop.
Wafrock says he'll continue waiting.
"I'm the first one who will take a pill for whatever ails me, but I think this is like chemotherapy. Who wants to subject their bodies to that for any length of time, unless they really have to," he said.
Dr. Carl Stein is a physician assistant. He recommends early treatment even though it's always up to the patient.
"Fortunately we have something like 25 drugs now and we have others in research and may become available in the next few years, so that we can tailor what's the best therapy for an individual patient's needs," he said.
Health officials also say they expect the new policy will help reduce the spread of HIV. That's because it's harder to transmit HIV if your viral load is undetectable and that's what happens when you take the medication, the virus become very low.