A 32-year-old man with newly diagnosed HIV (CD4 count 180 cells/μL, viral load 95,000 copies/mL) presents with a 2-week history of progressive dyspnea, fever, and dry cough. Chest X-ray shows bilateral interstitial infiltrates. Arterial blood gas reveals PaO₂ 65 mmHg on room air. What is the most appropriate next step in management?

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