What to know when starting HIV treatment

HIV (human immunodeficiency virus) is a chronic viral infection that destroys white blood cells and weakens the immune system. When the immune system is weakened, the body becomes more susceptible to infections and certain types of cancers. Left untreated, HIV can progress into AIDS (acquired immunodeficiency syndrome).

There is no known cure for HIV, but the infection can be managed. With continuous treatment with medication, a healthy lifestyle, and attention to healthcare, people who have HIV can enjoy good health and long lives.

If you have been diagnosed with HIV, it’s important to start treatment as early as possible. Treating early reduces damage to the immune system, lowers the risk of complications, and is associated with better long-term health. It also helps prevent transmission of the virus to other people.

Your best source of information about treating HIV will be your healthcare providers. When working with your healthcare providers, it helps to know what to expect from treatment and what questions to ask.

How HIV treatment works

HIV is treated with anti-retroviral therapy (ART). These are medications that stop the virus from replicating and reduce the amount of virus in the body. The amount of virus in the body is called the viral load.

The goal of treatment with ART is to achieve viral suppression (low amounts of HIV virus in the blood) or an undetectable viral load (a viral load so low it cannot be detected by standard blood tests).

Achieving either goal does not mean that HIV is cured. Continuous treatment with ART is required for the immune system to remain healthy and perform its normal functions—like protecting the body from opportunistic infections and healing wounds.

Different ARTs work in different ways. A person may take oral medications, or they may visit a healthcare provider regularly for injections. If a person takes oral medications, they will typically take a combination of different ARTs (called a regimen). The idea is to attack the virus at different points in its lifecycle. There are dozens of medications available, and your healthcare providers will select a regimen based on recommended guidelines and your individual needs.

Because HIV is a different experience for every person, it’s important to work with healthcare providers you trust. A healthcare team for HIV typically includes an infectious disease specialist, who in many cases will also act as a primary care provider. The specific providers a person will work with will depend on factors like what resources and providers are available where they live.

What to discuss with your healthcare providers

The first thing to discuss is whether you are ready to begin treatment for HIV. While it’s important to start treatment as early as possible, it’s also important to recognize that treating HIV is a lifelong commitment. Once treatment is started, it should not be paused or stopped.

Stopping treatment, pausing treatment, or even taking medications inconsistently can cause the virus to become resistant to treatment. This makes treatment more difficult in the future. It also puts a person at greater risk for complications from HIV, including AIDS.

Here are a few important topics to cover when you are talking with your healthcare providers as you begin treatment for HIV:

• Discuss any concerns you have about your ability to follow your treatment plan for HIV.
• Discuss any other health conditions you have or have had in the past, including any mental health conditions and substance use disorders.
• Discuss any health conditions that you may need to be screened for, such as hepatitis C, which is a common co-infection with HIV.
• Tell your healthcare provider about any medications you are already taking, including prescription medications, over-the-counter medications, and any supplements, including herbal supplements.
• Know the brand names and generic names of any HIV medications you are prescribed. Know your dosage for each.
• Know what your ARTs cost, if they are covered by insurance, and if they are affordable.
• Have clear instructions on how to take each medication or when to come in for injections.
• Ask what to do if you miss a dose of medication or an appointment for an injection.
• Ask about medications side effects that may occur.
• Ask about follow up appointments and exams. Blood tests will be used to monitor viral load and monitor treatment progress.

In addition to questions specifically about HIV treatment, it’s also important to discuss your overall health, including mental health, and what steps you can take to keep yourself as healthy as possible.