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The Goals of HIV Treatment and the Importance of Adherence

HIV treatment adherence is the key to maintaining viral suppression and healthy white blood cell counts.

Partnering with the right healthcare provider is one of the best ways to make sure you are getting the care you need when living with HIV.

There is no cure for human immunodeficiency virus (HIV), but there are treatments that can provide long-term control over an HIV infection. With continuous treatment, a person living with HIV can avoid illnesses caused by HIV (including AIDS), minimize the risk of spreading the virus to other people, and live a long and healthy life.

Here, we look at the goals of treating HIV and the strategies that can keep a person healthy while living with HIV.

Beginning treatment for HIV

If you have been diagnosed with HIV, your first goal is to begin treatment. HIV is treated with antiretroviral therapy (ART). ART medications reduce the amount of virus in the body and prevent the virus from multiplying. A person will take a combination of several ART medications, called a regimen. It is recommended that anyone who has HIV begin treatment with ART as soon as possible.

It is important to emphasize that ART medications cannot cure HIV. For ART to work, a person must take every dose of their HIV medication, and they must take every dose on schedule. A person must also continue taking their HIV medications for the rest of their life. This is called treatment adherence.

The goals of treating HIV

Treatment adherence is the foundation of long-term control of an HIV infection. Treatment adherence enables a person to meet the important goals of HIV treatment:

  • Viral suppression. One of the top goals of treating HIV is to keep the viral load as low as possible for as long as possible. Viral load means the amount of virus in the body. Ideally, a person will want to achieve and maintain an “undetectable viral load,” where the level of virus is so low it cannot be detected on a standard blood test.
  • Maintain a healthy immune system. HIV infects and destroys white blood cells. White blood cells are an essential part of the immune system. When white blood cell numbers are too low, the body will not be able to fight off infections and a person can become very sick.
  • Prevent transmission to other people. Keeping the virus at undetectable levels greatly reduces the risk of transmission of HIV to other people. This includes the risk of transmission to an unborn child during pregnancy and to infants during breastfeeding. It also includes the risk of transmission to intimate partners.
  • Prevent drug resistance. Taking breaks from ART and missing doses of ART medication can contribute to “drug resistance.” This means that HIV will no longer respond to certain ART medications and different medications will be needed. This can make treating HIV more difficult. It will mean a person has fewer treatment options in the future.

When living with HIV, you will have regular appointments with your healthcare provider. Attending these appointments is another important part of treatment adherence. Appointments will include tests to monitor white blood cell counts and viral load. They are also an opportunity to address any difficulties you have had with treatment or other areas of your health.

Good overall health and good quality of life are other important treatment goals. This means addressing any other health concerns, good nutrition, staying active, and taking care of mental health.

Partner with the right healthcare provider

Treating HIV is a lifelong process. One of the best ways to make sure that you are getting the care you need is to partner with the right healthcare provider. Important qualities to look for in a healthcare provider include:

  • They have experience treating HIV and they understand the challenges faced by people living with HIV.
  • They treat you with respect, listen to your concerns, and provide good explanations when you have a question.
  • They are someone you feel comfortable talking to. Treating HIV often involves discussing very personal topics, such as mental health and intimate relationships.

HIV is typically treated by a medical doctor called an infectious disease specialist. Some people with HIV are treated by a primary care provider who has experience treating HIV. Your healthcare provider will be your best source of information about treatment, treatment adherence, and staying healthy while living with HIV.

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Centers for Disease Control and Prevention. HIV Treatment.
National Institutes of Health HIVinfo. HIV Treatment Adherence.
UpToDate. Patient education: Initial treatment of HIV (Beyond the Basics).
HIV.gov HIV/AIDS Glossary. Adherence.
National Institutes of Health HIVinfo. Following an HIV Treatment Regimen: Steps to Take Before and After Starting HIV Medicines.
HIV.gov. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV.
Centers for Disease Control and Prevention. HIV Treatment as Prevention.
MedlinePlus. CD4 Lymphocyte Count.
HIV.gov. Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States.
National Institutes of Health HIVinfo. Drug Resistance.
HIV.gov. Seeing Your Health Care Provider.
HIV.gov. Aging with HIV.
Centers for Disease Control and Prevention. Healthy Living with HIV.
National Institute of Mental Health. HIV and AIDS and Mental Health.
HIV.gov. Types of Providers.
Centers for Disease Control and Prevention. Talking To Your Patients.
Sampath Wijesinghe and Jeffrey L. Alexander. Management and treatment of HIV: are primary care clinicians prepared for their new role? BMC Family Practice, 2020. Vol. 21.
IDSA Foundation. ID specialists or PCPs: Who should manage HIV primary care?

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