The Body

April 1, 2009

By Bonnie Goldman

Bonnie Goldman, Editorial Director of TheBody.com

Forget what you've heard about treatment for HIV. HIV treatment in 2009 is a world away from what it was even two years ago. Important new medications and older, proven medications can now be taken less frequently with reduced side effects.

Nonetheless, choosing HIV medications and determining when to begin treatment are big decisions. Fortunately, newly infected people not on treatment typically can go 10 years without a single symptom. This means that when you test positive for HIV, depending on when you were infected and what your CD4 count and viral load are, it's usually OK to wait to make an informed decision about using HIV medications.

To determine if you need to take HIV medications, your doctor will take at least two blood tests:

• a viral load test to see how much HIV is in your bloodstream, and

• a T-cell test, also known as a CD4 count, which tests how strong your immune system is.

To read more about these tests, view our overview.

Based on both your T-cell test and viral load test results, you and your doctor will have a clear picture of how HIV has progressed in your body and when you should start taking HIV medications.

When it comes to taking HIV medications, first answer this question: Is now the right time to start? Current U.S. guidelines recommend that you begin HIV treatment if your CD4 count is below 350 or if you've developed an opportunistic infection, but many experts believe HIVers should start treatment even earlier. The most important thing, though, is to talk with a knowledgeable HIV doctor to ensure that when you do start taking meds, it's for the right reasons, and you're ready to commit to taking every dose on time.

Once you decide to start treatment, the question becomes: What HIV meds should you take? With more than two dozen meds to choose from, the options can seem overwhelming. But there are established guidelines and blood tests (such as drug resistance testing and abacavir hypersensitivty testing) that can help you and your doctor determine the best choice for you.

To learn the basics about starting HIV treatment, check out these great overviews:

• Choosing and Working With a Good HIV Doctor (or Other Health Care Provider)

• Summary of U.S. HIV Treatment Guidelines

• Why Is There So Much Conflicting AIDS Information? Who Can You Believe?

• What Is Treatment Adherence, and Why Does It Matter?

• Frequently Asked Questions About When to Start HIV Treatment

• Is My Treatment Regimen Working?

• HIV Health Checklist: Recommended Lab Tests and Vaccines for People With HIV

And for more information, visit the following pages:

• HIV Treatment Basics

• Choosing and Working With a Physician

• HIV Monitoring Tests

• When to Begin Treatment

• HIV Treatment Guidelines

• HIV Medications

• Side Effects, Opportunistic Infections and Coinfections

• Personal Stories From HIVers on Starting Treatment

• Ask TheBody.com's Experts About Choosing Your Meds (Submit a Question Online!)

• Talk About HIV Treatment With Other HIVers at TheBody.com's Bulletin Boards