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Start -- and Continue -- HIV Meds as Soon as You Can

January 11, 2016

Joanna Eveland, M.D.

Joanna Eveland, M.D.

Sometimes, people who have just been diagnosed with HIV ask me when they need to start taking HIV medications. If you're living with HIV, you probably have heard that it's best to start antiretroviral therapy (ART) as soon as possible. Untreated HIV is more toxic to your body than HIV medications, so I always advise people to start HIV treatment right away.

But, some people may still be wary of starting HIV medication early on. They may not trust their provider or the federal agencies that make treatment recommendations. They may worry that the "medical establishment" is downplaying the toxicity of HIV medications in order for drug companies and unscrupulous doctors to make more money.

I've heard these concerns and know that as medical providers, we haven't always done a good job in listening to our patients and addressing their concerns. People who have been historically disenfranchised by the health care system, such as African Americans, may be even more distrustful. And it's true that there have been some doctors and researchers who were unethical and gave the rest of us a bad name. But I have read the research and know that the recommendation for people with HIV to start ART as soon as possible is based on good science, not greed. Here's what we know.

Why Wait?

For many years, the theory in HIV care was: "If it ain't broke, don't fix it." Doctors based their decision on whether or not to prescribe ART on their patients' CD4 cell counts (a measure of immune system health). If a person's CD4 count was high enough that we thought the person wasn't at risk of developing AIDS or a serious opportunistic infection, we advised the person to wait until their CD4 count dropped before starting HIV medications. We did this because we were taking into consideration the toxicity of HIV medications as we were weighing the costs and benefits of HIV treatment.

Three things happened in the last ten years to change the, "if it ain't broke, don't fix it" recommendation.

This excerpt was cross-posted with the permission of Read the full article.

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This article was provided by BETA. Visit their website at


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