When to Begin HIV/AIDS Treatment

See also: Treatment Guidelines | When to Start Treatment -- Research | Primary HIV Infection

From The Body's "Ask the Experts" Forums

I've heard that starting early when you don't need meds can be beneficial. I know this commitment shouldn't be taken lightly, and that there's a risk of becoming resistant. When should I start treatment?
My friend was recently diagnosed with HIV and told to start medication once his CD4 count falls below 200. Is that too late?
My CD4 count was 565 but after 10 months, it dropped very quickly to 388. My doctor thinks this drop is rather unusual and wants me to start HIV meds soon. Does this large CD4 drop mean that I should start medication?

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FAQs About Starting HIV Treatment (From The Body's "Ask the Experts" Forums) (Regularly Updated)
From The Body's "Ask the Experts" Forums
When to Start Anti-HIV Medications (November 2011)
Part of HIV and Its Treatment.
To read PDF, click here.
From AIDSinfo
Starting HIV Medications: Preparing For a Life-Saving Challenge (August 17, 2011)
Starting HIV treatment is a lifesaving decision, but it's also a huge commitment. David Fawcett, Ph.D., L.C.S.W., shares six of the most important factors to keep in mind as you prepare to take HIV meds for the first time.
From The Body
10 Questions to Ask Yourself Before You Begin HIV Treatment
An HIV diagnosis comes with its very own set of questions to ask yourself and decisions to make. Among the biggest is: When should you start treatment? It's a Russian nesting doll of a decision, with many other questions tucked inside.
From The Body
What You Should Know About When to Start and What Meds to Use (July 2011)
Part of Project Inform's "Attaining HIV Health and Wellness" booklet series.
To read PDF, click here.
From Project Inform
U.S. Mulls Implications of Early Use of HIV Drugs to Stop AIDS Spread (May 27, 2011)
In CDC HIV/Hepatitis/STD/TB Prevention News Update, from U.S. Centers for Disease Control and Prevention
Immediate Treatment for All of Us? PrEP for Everyone Else? (May 11, 2011)
From Black AIDS Institute
Ask the Doctor: At What T-Cell Count Should a Person Begin Treatment? (March 15, 2011)
Time to Start? (Winter 2011)
To read PDF, click here.
In The Positive Side, from Canadian AIDS Treatment Information Exchange
Early Initiation of ART Should Be First Priority (December 24, 2010)
In Kaiser Daily Global Health Policy Report, from Henry J. Kaiser Family Foundation
HIV Medications: When to Start and What to Take (December 2010)
The Body's easy-to-read online guide to HIV treatment.
To read PDF, click here.
In HIV Medications: When to Start and What to Take -- A Roadmap to Success, from The Body
Late Presentation for HIV Care in the United States and Canada (September 8, 2010)
In CDC HIV/Hepatitis/STD/TB Prevention News Update, from U.S. Centers for Disease Control and Prevention
San Francisco Adopts Early Treatment (Summer/Fall 2010)
To read PDF, click here.
In Bulletin of Experimental Treatments for AIDS, from San Francisco AIDS Foundation
HIV Wellness Series: Ready, Set ... When? (July/August 2010)
Debate continues over when to begin treatment.
To read PDF, click here.
In Positively Aware, from Test Positive Aware Network
To Start, or Not to Start? (July/August 2010)
Leading advocates and physicians offer their thoughts on a new study.
To read PDF, click here.
In Positively Aware, from Test Positive Aware Network
HIV Drugs Should Be Initiated Earlier, Says UN (July 19, 2010)
In CDC HIV/Hepatitis/STD/TB Prevention News Update, from U.S. Centers for Disease Control and Prevention
The Return of "Hit Hard, Hit Early!" (Spring 2010)
Just when you thought it was safe to wait ...
To read PDF, click here.
In Achieve, from ACRIA and GMHC
The Rationale for TLC+, and Project Inform's Position on When to Start HIV Treatment (May 12, 2010)
From Project Inform
Project Inform's Position on When to Start HIV Treatment (May 2010)
To read PDF, click here.
From Project Inform
Little Soldiers and Superheroes: A Blog Entry by Philip D. (March 30, 2010)
From The Body
A Hundred Indecisions: A Tale of Starting Meds: A Blog Entry by fogcityjohn (March 17, 2010)
From The Body
Will U.S. DHHS Guidelines Recommend Even Earlier Treatment Initiation? (March 8, 2010)
Part of a CROI 2010 wrap-up discussion with Joel Gallant, M.D., M.P.H.
In The 17th Conference on Retroviruses and Opportunistic Infections, from The Body PRO
Considering HIV Treatment (January 2010)
From The Well Project
Expert Panel Revises U.S. HIV Treatment Guidelines; Recommends Starting HIV Meds Earlier (December 1, 2009)
From The Body
When to Start: A Debate (Summer 2009)
To read PDF, click here.
In Achieve, from ACRIA and GMHC
HIV's Silent Dangers Make Early HIV Treatment Critical, Expert Says (July 21, 2009)
A discussion about inflammation, early treatment and universal treatment access -- Wafaa El-Sadr, M.D., M.P.H., United States.
In The 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention, from The Body PRO
Growing Evidence Supports Early Treatment (June 24, 2008)
From Project Inform
Strategies for HIV Therapy (April 2008)
To read PDF, click here.
From Project Inform
Voices Grow Louder in Support of Earlier HAART Initiation (January 12, 2007)
From aidsmap.com
Under Starter's Orders (March 2006)
Should everyone start HIV therapy when their CD4 count drops below 250? Or is it different strokes for different folks?.
From Positive Nation
Starting Treatment, Staying on Therapy (January/February 2005)
[Archived Article]
Ross Slotten, M.D., reviews the evolution of the "when to start" debate in HIV treatment.
To read PDF, click here.
In Positively Aware, from Test Positive Aware Network
Patient/Doctor Q&A With Patrick McNamara, M.D. (October 2004)
[Archived Article]
Questions about starting meds, controlling diarrhea and using Sculptra to treat facial wasting.
To read PDF, click here.
In HIV Treatment ALERTS!, from The Center for AIDS
Table: Helping HIV-Infected Persons Decide When to Start HAART (March 2004)
[Archived Article]
Modified from the Nov. 2003 U.S. Department of Health treatment guidelines.
In HEPP Report, from Brown Medical School
When Should I Start Treatment? (March 2004)
[Archived Article]
To read PDF, click here.
From Project Inform
Starting Anti-HIV Therapy (January 2004)
[Archived Article]
To read PDF, click here.
In Project Inform Perspective, from Project Inform
CROI 2003: When, and With What, to Initiate Antiretroviral Treatment (February 14, 2003)
[Archived Article]
In The 10th Conference on Retroviruses and Opportunistic Infections, from The Body PRO
Many HIV Positive People Begin Treatment Late (Summer/Autumn 2002)
[Archived Article]
In Bulletin of Experimental Treatments for AIDS, from San Francisco AIDS Foundation
Federal Guidelines for the Use of Anti-HIV Therapy (December 2001)
[Archived Article]
To read PDF, click here.
In WISE Words, from Project Inform
Walking Your Way Through Making a Decision (December 2001)
[Archived Article]
To read PDF, click here.
In WISE Words, from Project Inform
Positive Voices: Words of Experience From Positive Women (December 2001)
[Archived Article]
Interviews with two HIV-positive women who debated when to start therapy.
To read PDF, click here.
In WISE Words, from Project Inform
Be Afraid of Osama, Not Your HIV (November 2001)
[Archived Article]
Rich Arenschieldt on why holding off on HIV drug therapy can be a smart move.
To read PDF, click here.
In HIV Treatment ALERTS!, from The Center for AIDS
"Fighting for Your Life: How to Survive a Life-Threatening Illness" (July 2001)
[Archived Article]
Excerpt and review.
In Body Positive, from Body Positive
ABC of AIDS: Natural History and Management of Early HIV Infection (May 26, 2001)
[Archived Article]
In British Medical Journal
The Buzz: The Importance of Sequencing in Treatment Options (May/June 2001)
[Archived Article]
To read PDF, click here.
In Positively Aware, from Test Positive Aware Network
To Start or Not to Start? Still Looking for Answers (Spring 2001)
[Archived Article]
To read PDF, click here.
In CRIA Update, from AIDS Community Research Initiative of America
Making Decisions About Treatment (March 2001)
[Archived Article]
To read PDF, click here.
In Project Inform Perspective, from Project Inform
Getting Started With Antiretrovirals: Thoughts on Initial Therapy (Spring 2001)
[Archived Article]
To read PDF, click here.
In CRIA Update, from AIDS Community Research Initiative of America
When to Start Treatment (March 2001)
[Archived Article]
To read PDF, click here.
In Project Inform Perspective, from Project Inform
The Case Against a When-to-Start Antiretroviral Therapy Trial (Spring 2001)
[Archived Article]
In Research Initiative/Treatment Action!, from The Center for AIDS
Think About It: Too Smart for Our Own Good (Spring 2001)
[Archived Article]
In Research Initiative/Treatment Action!, from The Center for AIDS
Hitting HIV Early: A Swift Attack on the Virus Is a Sound Strategy (December 2000)
[Archived Article]
In Positive Living, from AIDS Project Los Angeles
To Med or Not to Med? Mental Health Aspects of Treatment Decision Making (November 2000)
[Archived Article]
In Body Positive, from Body Positive
Stop, Start, Switch (June 2000)
[Archived Article]
From AIDS Community Research Initiative of America
HIV Armageddon: Hit Hard, Hit Early? An Interview With Dr. Mary Romeyn (May/June 2000)
[Archived Article]
In Positively Aware, from Test Positive Aware Network
Millennial Heresy (April 2000)
[Archived Article]
In Project Inform Perspective, from Project Inform
Agonizing Reappraisal of Early Antiretroviral Therapy (Spring 2000)
[Archived Article]
"Hit Early" takes a beating after the 7th Retrovirus Conference.
In GMHC Treatment Issues, from Gay Men's Health Crisis
Has the Pendulum Swung Too Far in the Opposite Direction? (Spring 2000)
[Archived Article]
Better stop your stoppin'. Dr. Steven Miles worries that too many patients are quitting anti-HIV therapy because of its side effects.
In GMHC Treatment Issues, from Gay Men's Health Crisis
Early Treatment May Not Be Best (November 1999)
[Archived Article]
From the 39th Interscience Conference on Antimicrobial Agents and Chemotherapy.
In Positive Living, from AIDS Project Los Angeles
Points to Think About for People Who Consider Taking Anti-HIV Therapy (October 1999)
[Archived Article]
From Project Inform
Time-Out/Time-In (September/October 1999)
[Archived Article]
Suspending one's drug regimen: when to start and when to stop.
In Positively Aware, from Test Positive Aware Network
Data Drought: As Treatment Euphoria Ebbs, Stubborn Uncertainties Resurface But Are Unlikely to Be Resolved (June 1999)
[Archived Article]
Mark Harrington discusses when to start antiviral therapy.
In TAGline, from Treatment Action Group
Early or Late? Arguments for Immediate Antiretroviral Therapy Versus Delayed Antiretroviral Therapy (June 1999)
[Archived Article]
In TAGline, from Treatment Action Group
HIV Research Overview: Interview with David Ho, M.D. (November 7, 1997)
[Archived Article]
In AIDS Treatment News, from AIDS Treatment News
Downward Trends in AIDS Deaths and Hospitalizations, but Not for All, and for a Variety of Reasons (March 1997)
[Archived Article]
In GMHC Treatment Issues, from Gay Men's Health Crisis