HIV Treatment

To protect your health, it is important to get on and stay on HIV treatment. HIV treatment is important because it helps your body fight HIV. You may hear the phrase “treatment adherence,” which means staying on your treatment plan. Most people living with HIV who don’t get treatment eventually develop AIDS.

If left untreated, HIV attacks your immune system and can allow different types of life-threatening infections and cancers to develop. If your CD4 cell count falls below a certain level, you are at risk of getting an opportunistic infection. These are infections that don’t normally affect people with healthy immune systems but that can infect people with immune systems weakened by HIV infection. Your health care provider may prescribe medicines to prevent certain infections.

HIV treatment is most likely to be successful when you know what to expect and are committed to taking your medicines exactly as prescribed. Working with your health care provider to develop a treatment plan will help you learn more about HIV, manage it effectively, and make decisions that help you live a longer, healthier life. HIV treatment will also greatly reduce your chance of transmitting HIV to sex partners and injection drug-use if taken consistently and correctly.

Treatment guidelines from the U.S. Department of Health and Human Services recommend that a person living with HIV begin antiretroviral therapy (ART) as soon as possible after diagnosis. Starting ART slows the progression of HIV and can keep you healthy for many years.

If you delay treatment, the virus will continue to harm your immune system and put you at higher risk for developing opportunistic infections that can be life threatening.

Antiretroviral therapy (ART) is the use of HIV medicines to treat HIV infection. There are five different types of HIV medicines. Each medicine helps stop HIV at different points in the virus’ life cycle.

When taken consistently and correctly ART helps:

• Reduce your viral load (the level of HIV in your body). When you reduce your viral load, you reduce HIV’s ability to infect new CD4 cells.
• Keep your immune system healthy by increasing your CD4 count. CD4 cells help protect you from developing infections. The right dose and type of ART medicines can help to keep your viral load low and your CD4 cell levels high.
• Prevent opportunistic infections and other illnesses.
• Reduce, but not eliminate, the chances that you will transmit HIV to others.
• Reduce, but not eliminate, the chances that you will transmit the virus to your baby if you are pregnant or plan on becoming pregnant.

Follow your treatment plan exactly as your health care provider has prescribed. Medicines should be taken at specific times of the day, with or without certain kinds of food. If you have questions about when and how to take your medicines, talk to your health care provider or pharmacist.

ART is usually taken as a combination of 3 or more drugs to have the greatest chance of lowering the amount of HIV in your body. Ask your health care provider about the availability of multiple drugs combined into 1 pill. Your health care provider and pharmacist will help you find a treatment combination that works best for you. If the HIV medicines you are taking are not working as well as they should, your health care provider may change your prescription. A change is not unusual because the same treatment does not affect everyone in the same way.

Let your health care provider and pharmacist know about any medical conditions you may have and any other medicines you are taking. Medicines you are taking for other health conditions may interact with your HIV treatment. These conversations will help you receive the best treatment possible. Additionally, if you or your partner is pregnant or considering getting pregnant, talk to your health care provider to determine the right type of ART that can greatly reduce the risk of transmitting HIV to your baby.

Like most medicines, antiretroviral therapy (ART) can cause side effects. However, not everyone experiences side effects from ART.

Some common side effects of ART that you may experience can include:

• Nausea and vomiting,
• Diarrhea,
• Difficulty sleeping,
• Dry mouth,
• Headache,
• Rash,
• Dizziness,
• Fatigue, and
• Pain.

Side effects can differ for each person and each type of ART medicine. Some side effects can occur once you start a medicine and may only last a few days or weeks. Other side effects can start later and last longer.

Contact your health care provider or pharmacist immediately if you begin to experience problems or if your treatment makes you sick. Medicines are available to help reduce or eliminate side effects or you can change medicines to find a treatment plan that works for you. Your health care provider may prescribe medicines to help manage the side effects or may decide to change your treatment plan.

Taking your HIV medicines exactly the way your health care provider tells you to will help keep your viral load low and your CD4 cell count high. If you skip your medicines, even now and then, you are giving HIV the chance to multiply rapidly. This could weaken your immune system, and you could become sick.

Talk to your health care provider if you miss a dose. In most cases, if you realize you missed a dose, take the medicines as soon as you can, then take the next dose at your usual scheduled time (unless your pharmacist or health care provider has told you something different).

If you find you miss a lot of doses, talk to your health care provider or pharmacist about ways to help you remember your medicines. You and your health care provider may even decide to change your treatment regimen to fit your health care needs and life situation, which may change over time.

Yes, antiretroviral therapy (ART) reduces viral load, ideally to an undetectable level. If your viral load goes down after starting ART, then the treatment is working, and you should always take your medicine as prescribed by your health care provider. Even when your viral load is undetectable, HIV can still exist in semen, vaginal and rectal fluids, breast milk, and other parts of your body, so you should continue to take steps to prevent HIV transmission. Taking your HIV medications on schedule will help keep your viral load very low and help you maintain your health. It will also make it more difficult for you to pass HIV on to others.

Sticking to your HIV treatment provides many benefits. Among them, it:

• Allows HIV medications to reduce the amount of HIV in your body. If you skip your medications, even now and then, you are giving HIV the chance to multiply rapidly. Keeping the amount of virus in your blood as low as possible is the best way to protect your health.
• Helps keep your immune system stronger and better able to fight infections.
• Reduces the risk of passing HIV to others. Staying on your treatment plan and keeping the amount of HIV in your body as low as possible means that it is less likely that you can pass the virus to others.
• Helps prevent drug resistance. Drug resistance develops when the virus changes form and no longer responds to certain HIV medications. This is a problem because that drug no longer works on your HIV. Skipping your medicines makes it easier for drug resistance to develop. Also, HIV can become resistant to the medications you are taking or to similar ones that you have not yet taken. This limits the options for successful HIV treatment. Drug-resistant strains of HIV can be transmitted to others, too.

Staying on an HIV treatment plan can be difficult. That is why it is important to understand some of the challenges you may face and to think through how you might address them before they happen. For example, remembering when to take your medicines can be complicated. Some treatment plans involve taking several pills every day—with or without food—or before or after other medications. Making a schedule of when and how to take your medicines can be helpful. Or ask your health care provider about the availability of multiple drugs combined into one pill.

Other factors can make sticking to your treatment plan difficult:

• Problems taking medications, such as trouble swallowing pills, can make staying on treatment challenging. Your health care provider can offer tips and ideas for addressing these problems.
• Side effects from medications, for example, nausea or diarrhea, can make a person not want to take them. Talk to your health care provider. There are medicines or other support, like nutritional counseling to make sure you are getting important nutrients, which can help with the most common side effects. But don’t give up. Work with your health care provider to find a treatment that works for you.
• A busy schedule. Work or travel away from home can make it easy to forget to take pills. Planning ahead can help. Or, it may be possible to keep extra medicines at work or in your car for the times that you forget to take them at home. But make sure you talk to your health care provider—some medications are affected by extreme temperatures, and it is not always possible to keep medications at work.
• Being sick or depressed. How you feel mentally and physically can affect your willingness to stick to your treatment plan. Again, your health care provider is an important source of information to help.
• Alcohol or drug use. If substance use is interfering with your ability to keep yourself healthy, it may be time to seek help to quit or better manage it.
• Treatment fatigue. Some people find that sticking to their treatment plan becomes harder over time. Every time you see your health care provider, make it a point to talk about staying on your treatment plan.

Your health care provider will help you identify barriers to staying on your plan and ways to address those barriers. Understanding issues that can make staying on your treatment plan difficult will help you and your health care provider select the best treatment for you.

Tell your health care provider right away if you’re having difficulty sticking to your plan. Together you can identify the reasons why you’re skipping medications and make a plan to address those reasons. Joining a support group, or enlisting the support of family and friends, can also help you stick to your treatment plan.  

Preparing to stay on your treatment plan before you start taking antiretroviral therapy (ART) is the first step to treatment success. Planning ahead will help you follow your treatment plan once you start treatment.

Begin by talking to your health care provider. Make sure you understand why you’re starting HIV treatment and why sticking to your treatment plan is important. Discuss these important details about your treatment plan:

• Each HIV medication that you will take.
• The dose (amount) of each HIV medication in your plan.
• How many pills in each dose.
• When to take each medication.
• How to take each medication—with or without food.
• Possible side effects from each medication, including serious side effects to watch out for.
• How to store your medications.
• Other medications you are taking and how they may interact with your HIV medications.
• Any personal issues such as depression, alcohol or drug abuse, lack of secure housing, or additional medical issues.
• Lack of health insurance to pay for anti-HIV medications.

Tell your health care provider if you have any personal issues, such as depression or alcohol or drug use, that can make staying on your treatment plan difficult. If needed, your health care provider can recommend resources to help you address these issues before you start treatment.

Some tips that may help you stick with your treatment plan are:

• Take your medicine at the same time each day.
• Match your medicine schedule to your life. Add taking your medicines to things you already do each day, like brushing your teeth or eating a meal.
• Try a weekly or monthly pill tray with compartments for each day of the week to help you remember whether or not you took your medicine that day.
• Set an alarm on your clock, watch, or phone for the time you take your medicines.
• Use a calendar to check off the days you have taken your medicines.
• Download a free app from the Internet to your computer or on your smartphone that can help remind you when it’s time to take your medicines. Search for “reminder apps,” and you will find many choices.
• Ask a family member or friend to help you remember to take your medicine.

You can also view stories and testimonials on this website of how people living with HIV are sticking to their treatment plans.