What to Know When Starting HIV Treatment

How HIV treatment works and what to discuss with your healthcare providers when you are ready to begin treatment.

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.

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. Untreated, HIV can progress into AIDS (acquired immunodeficiency syndrome).

There is no known cure for HIV, but HIV 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 transmitting 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 (the viral load is so low that 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. Typically, a person will 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 ARTs 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 that 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, though 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, and 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 (hepatitis C for example, which is a common co-infection with HIV).
  • Tell your healthcare provider about any medications that 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 all the HIV medications you are prescribed. Know your dosage for each.
  • Know what your medications cost, if they are covered by insurance, and if they are affordable.
  • Have clear instructions on how to take each medication.
  • Ask what to do if you miss a dose of medication.
  • 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.

Article sources open article sources

MedlinePlus. HIV. What Are HIV and AIDS?
Centers for Disease Control and Prevention. HIV Treatment. Aging with HIV.
UpToDate. Patient education: Initial treatment of HIV (Beyond the Basics). HIV Treatment Overview.
National Institutes of Health. HIV Treatment: The Basics. HIV Treatment Overview.
National Institutes of Health. What to Start: Choosing an HIV Treatment Regimen.
IDSA Foundation. ID specialists or PCPs: Who should manage HIV primary care?
Centers for Disease Control and Prevention. HIV: Understanding Care. What to Expect at Your First HIV Care Visit.
National Institutes of Health. HIV Treatment Adherence.
National Institutes of Health. HIV and Substance Use. Seeing Your Health Care Provider. Lab Tests and Results.

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