HIV meds have not been studied as much in women. Some questions remain about the doses given to women. Female hormones may also affect HIV meds.
However, the recommendations for when to start and what to choose are generally the same for both sexes. Women who are not pregnant, planning to become pregnant, breast-feeding or taking hormonal birth control can follow the same guidelines as men.
Women sometimes experience both a higher rate and different types of side effects from HIV meds than men, likely due to differences in their weight and body size. In some cases side effects can persist longer for women than for men, but usually decline over time.
Oral contraceptives can interact with some HIV meds. It's not clear whether this actually raises the risk of unintentional pregnancy, but some experts recommend that prescriptions should be changed or other forms of birth control should be used.
With careful planning and ongoing care, pregnant women can expect to have a safe pregnancy and to give birth to an HIV-negative baby. Although HIV meds have not been well studied in pregnant women, the US Guidelines recommend that all pregnant women be on treatment to protect themselves and their unborn babies. Some meds appear to be safer, some can be more problematic, and a few others should not be used at all. When making decisions around pregnancy, delivery and nursing, it's wise to consult an HIV-experienced doctor, such as an OB-GYN who has treated HIV-positive women.
It can be hard to take medicines and stay on them when you're feeling well. It's easier to remember and take them when you feel sick because you want to feel better. But HIV meds are taken every day -- whether you feel good or feel bad.
It's difficult to fully grasp the meaning of "lifelong" treatment, but once you start HIV meds you need to stay on them. How do you feel about taking pills every day? Have you taken other medicines or vitamins long-term? How about family or friends? What were their experiences?
Adjusting to several changes in your life at once can be hard. You may want to avoid starting meds before disrupting life experiences like going on vacation, moving or starting a new job. What flexibility do you have with commitments like caring for children or volunteering? How will you carry your meds?
It's generally better to not start until you're ready rather than to start and stop. You're the expert on when you can start in a way that helps ensure your quality of life.
For many, privacy is an important consideration when taking HIV medicines. Taking them on time every day or going to regular doctor visits may raise suspicions of some people in your life. Discrimination or disapproval from others can make it challenging to take care of yourself. When possible, discretely telling people who support you may help you stay healthier.
Modern HIV regimens generally have fewer and more manageable side effects, and many people tolerate them quite well. Although most people wonder or worry about side effects, it's impossible to predict who will have them. Some people have few or no side effects, while others have ones that are more troublesome for them. The side effects one person has from a particular medicine does not mean everyone else will have the same ones.
Short-term side effects (headache, fever, nausea, etc.) normally appear during the first few weeks of taking a new drug. They often get better or disappear as your body gets used to the meds. They can reappear due to stress or other infections.
People with better overall health usually experience fewer short-term side effects. If you start later when you're less healthy, you may experience more side effects. However, if your regimen interrupts your quality of life, you can probably switch to another one that you can tolerate better.
You and your doctor will keep track of long-term side effects with routine blood tests. These can include changes in blood fats or in certain blood proteins (such as ALT, AST, amylase and creatinine) that point to possible problems with certain organs, including the liver and kidneys. Over time, these changes can progress to other conditions like more fragile bones or kidney and liver disease.
Drug interactions are possible whenever you take two or more drugs together, whether they're prescriptions, over-the-counter drugs like cold medicine, recreational drugs or even herbal products. Even food can interact with drugs. The more meds you take, such as meds for high blood pressure or even erectile dysfunction, the more likely you could experience an interaction. This is also true about taking HIV meds with some herbal products, especially St. John's Wort.
Not only does each drug or herb have its own possible side effects, they may also increase or decrease the effectiveness of other drugs. Drug interactions are not always considered when making treatment decisions, but they can certainly play a major role in its success.
Make sure your doctor knows about all the drugs and supplements you take, including over-the-counter products and recreational drugs. Your pharmacist can also be a good resource. Drug interaction tools are also available online.