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Considering HIV Treatment

May 5, 2015

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Considering HIV Treatment

Table of Contents

Are You Ready?

Treatment with HIV drugs can improve quality of life and help people living with HIV (HIV+) stay healthier longer. But starting treatment is a big decision. In order to get the most benefit from HIV drugs, they must be used just the way they are prescribed. Taking your treatment correctly is as important as which drugs you and your health care provider choose. So before you get started, it is important that you be able to commit to taking your HIV drugs the right way, every day for your own health! This takes a combination of the right health care provider, enough knowledge about HIV, and a positive attitude.


The Right Health Care Provider

In an ideal world, you and your health care provider are a team working together to make the best treatment decisions for you. You may want to ask yourself a few questions about your relationship with your health care provider: Do I have confidence in my provider? Can I be totally honest with him or her? Is she or he available when I have questions? Does he or she take my concerns seriously? If so, great!

If not, you may want to make some changes. Although it can be difficult, you may want to ask your provider directly if she or he will be available for questions. If you do not feel fully respected or taken seriously, you may consider telling your provider that you are concerned that your relationship is not as strong as it could be because of how you feel. It may help to write down the questions you would like to ask your health care provider before you go to visits. Finally, it is always important to answer your provider's questions with the truth, not with what you think she or he wants to hear. If these steps still do not work, it may be time to look for another provider.

It is also wise to have a health care provider who is an HIV specialist. Health care providers who devote most of their time to HIV are best able to manage this condition. Helpful suggestions for HIV specialists near you can come from friends and/or ASOs (AIDS Service Organizations), or by checking with the American Academy of HIV Medicine (AAHIVM). To find an ASO in your area, click here or look at the AAHIVM's Referral Link. For services worldwide, please use AIDSmap's e-atlas.

Knowledge About HIV

The Basics

HIV is a virus that destroys CD4 cells. CD4 cells are part of the body's immune system. The immune system protects the body from germs such as bacteria, fungi, and other viruses. When the immune system loses too many CD4 cells, it becomes weak and is unable to fight off germs, leading to opportunistic infections (OIs) that can cause serious illness or death.

HIV Treatments

Scientists have developed drugs that stop HIV from making copies of itself (multiplying). These drugs are grouped into classes. Each class of drugs works to stop HIV at a certain point in its life cycle. There are six classes of drugs:

  • Entry inhibitors (including fusion inhibitors and CCR5 antagonists)
  • Integrase inhibitors
  • Nucleoside/nucleotide reverse transcriptase inhibitors ("nukes" or NRTIs)
  • Non-nucleoside reverse transcriptase inhibitors ("non-nukes" or NNRTIs)
  • Protease inhibitors (PIs)
  • Boosting agents

HIV drugs are always used in combination to attack the virus at different points in its life cycle. This usually means using drugs from at least two different classes. Combining HIV drugs is the best way to reduce the amount of HIV in your blood (viral load).

Baseline Blood Tests

Before you start HIV treatment, your health care provider should have you take a number of blood tests. These are your original, or baseline tests. Future test results will be compared to your original or baseline results to see how you are doing and how well your treatment is working.

  1. CD4 cell (T-cell) count: The CD4 count checks the strength of your immune system. After you start HIV treatment, you should see your CD4 count go up. Your CD4 count should be checked every three to four months, if possible, then every six months to one year, once it has become stable.
  2. Viral load test: The viral load test measures the amount of HIV in your blood. After you start HIV treatment, you should see your viral load go down. Your viral load should be checked about a month after you start or change HIV drugs. After that, it should be checked every three to four months, then every six months, once it has become undetectable in your bloodstream and stays undetectable.
  3. Resistance test: The resistance test helps determine which drugs are likely to work against the strain of HIV you have. Experts recommend that everyone get a resistance test before starting or changing HIV treatments, even if you do not plan to start HIV treatment for a while.
  4. Other tests to check your overall health: These include complete blood count (CBC), chemistry screen, lipid profile (cholesterol and fat), liver tests, and glucose (blood sugar). Your health care provider should talk with you about how often these tests need to be done.

Treatment Goals

  • To get your viral load as low as possible for as long as possible
  • To preserve or improve the health of your immune system by increasing your CD4 cells
  • To improve your quality of life and reduce illness
  • To reduce your risk of spreading HIV to others
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This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.

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