Would You Treat Your HIV With a Monthly Injection Instead of Daily Pills?

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This past summer, the pharmaceutical company ViiV Healthcare announced that the latest leg of its ATLAS trial had found that its monthly injectable two-med regimen worked just as well over six months to get HIV to undetectable as the typical contemporary three-drug regimen you pop daily by mouth at home.

A study released earlier this year found that those taking the drug in trials considered the mild side-effects -- including brief injection-site bruising like after getting a typical shot -- a small price to pay for not having to take HIV meds or think about one's HIV status every day, not to mention hiding one's HIV meds.

More data on the injectable, which combines the drugs rilpivirine (Edurant) and cabotegravir, will likely come out later this year.

Meanwhile, we asked eight diverse HIV-positive folks (nine, really!) from around the country whether they'd consider switching to an injectable. We even asked a bonus question!

Anyway ... what do you think about injectables versus orals? Share this on social and start a conversation!

Tim Murphy has been living with HIV since 2000 and writing about HIV activism, science and treatment since 1994. He writes for and has been a staffer at POZ, and writes for the New York Times, New York Magazine, Out Magazine, The Advocate, Details and many other publications. He is also the author of the NYC AIDS-era novel Christodora.


Selfie by Keiva Lei Cadena

Keiva Lei Cadena

Cadena is a community health engagement coordinator at Hawai'i Health and Harm Reduction Center, Honolulu. Cadena is 43 years old, and was diagnosed with HIV in 2004.

I've been on my current regimen the past year and a half. It's going much better, the easiest medication I've taken. Back in early 2014, I switched from one regimen to another and had a lot of problems, so I switched again. I still had problems. I told my doctor, "I can't take this anymore; I'm stopping now." Then my viral load shot up to 50,000 within two weeks, which was scary. Honestly, I don't think I would be open to this injectable. I like the freedom of taking a daily med on my own versus having another doctor's appointment. What if I'm not in town or able to get to the doctor? Life is simple now with my once-daily pill.

Bonus Question: How have you coped with your regimen challenges?

Answer: I'm lucky because I work in the field and stay connected to information, and I normalize conversations around HIV and wellness. I looked to my support system, colleagues, and coworkers. My viral surge was really a wake-up call that medication plays a key role in keeping me well.


Brogan McGowan

Clarisse Jordan

Jordan is a volunteer at Allies for Health + Wellbeing, Pittsburgh. Jordan is 48 years old, disabled, and was diagnosed with HIV in 1989.

I've been on my current regimen for about four months. It's working really well for me -- just a little headache and sometimes some stomach nausea but nothing big. I remember when I suffered all day with side effects. I don't know about switching to an injectable. I'd have to hear more about it and study the research. It seems like something strong enough to sustain you for a whole month would have high side effects. How does it affect women and African-American women?

Bonus Question: What tips have you learned for maintaining adherence to your regimen all these years?

Answer: I know that if I take my meds the way I need to, I can be undetectable and live a normal life. All I have to do is pop a pill and it saves my life.


Selfie by Judith Dillard

Judith Dillard

Dillard lives in Ft. Worth, Texas. She is 64 years old, disabled, and was diagnosed with HIV in 1990.

My current regimen is easy and working well for me. I've been undetectable the past seven years straight. I wouldn't consider switching to an injectable. At this point, I'm going into my 29th year with HIV, and if this pill is working for me, I'm gonna keep taking it. I don't know if that injectable will work for my body. One pill a day is so easy for me. I never thought I'd be on a once-daily regimen.

Bonus Question: What would you say to another longtime HIV survivor who said, "I'm getting tired of taking my meds?"

Answer: I'd ask, "Are you saying you're tired of living? Because the medication has kept you alive this far. Why do you want to go off it now? You need support here -- and not just your family. Can you find an HIV peer group that keeps one another lifted up?"


Rohan

Derrick "Strawberry" Cox

Cox is an entertainer, activist, and health department worker in Washington, D.C. Cox is 29 years old and was diagnosed with HIV in 2011.

My new regimen is going good -- no side effects, and it's a small pill. I've heard about the injection coming. If it goes well with my system, I'd be open to trying it. I don't like needles, but if I can get one needle to take care of my HIV for a whole month, I'd try it. I don't like taking pills every day. Yes, I take my vitamins -- but they're chewable gummies!

Bonus Question: What's your advice to the newly diagnosed?

Answer: I run a peer-plus-one program here at Whitman-Walker Health in D.C., so my advice is, "I understand, I've been through it, but just see your HIV regimen as your daily multivitamin and add it to your meal: breakfast, lunch, or dinner."


Selfie by Dale Sundstrom

Dale Sundstrom

Sundstrom is a retired graphic designer and facilitator of a peer support group for long-term survivors at Whitman-Walker Health, Washington D.C.

I've been on my current regimen about two years. It's really the first combo where I haven't had noticeable side effects, so I'm pretty happy with it. Prior to it, I had a lot of gastrointestinal distress, neuropathy, headaches, and a whole variety of things -- even seizures! But yes, I would be open to a monthly injectable. I'd have some reservations. I'd wanna see what the side-effect profile was. And I have concerns about high levels of drug in your bloodstream for a month. But I'd be open because it would eliminate the anxiety of "Have I taken my pills?" and not having to use pill-reminder things.

Bonus Question: What have you learned all these years about adherence?

Answer: It's very important! But it's also important not to freak out if you aren't adherent for one or two days. Everybody runs into a point where they don't make it to the pharmacy.


Selfie by Victor Benadava Aviance

Victor Benadava Aviance

Aviance lives in Staten Island, New York. He is 56 years old and was diagnosed with HIV in 2000.

I've been on my current regimen about five years. I actually take it every two days, and I'm undetectable, but I urge that no one do this without talking first to their doctor. Taking it daily made me depressed and nauseous. I still have a little nausea from it. I can feel it right away when I take it. So, if an injection were only once a month, I would try it. I wouldn't have this daily reminder that I am HIV positive.

Bonus Question: If a friend said to you, "I was just diagnosed with HIV and now I have to take meds every day...?"

Answer: Honey, save your life and get on those meds!


Lovans Florial

Brenda Emily

Emily is a café server in Milford, Pennsylvania. Emily is 22 years and was diagnosed with HIV at birth.

I've been taking my current regimen for two years, and it's really good -- the only regimen I've been able to take where I have no side effects, and it's only two pills. I take it and don't even think about it. I started struggling with adherence in college when taking meds became my own responsibility. I was suddenly facing depression over what it meant to live with HIV, especially in college with all the partying and hookups. So, I stopped taking my meds -- only to realize that all my childhood sluggishness and headaches were from side effects.

My doctor and I argued over this for three years. Finally, I convinced her to put me on this current regimen based on my own research --and I've had no issues. I only don't take it briefly when I get low with my mental health. So, when I first heard about the injectables, I was so excited that that could be a thing. If I could just get it once a month and not think about it, I'm definitely open to it.

Bonus Question: What are your tips and tricks for adherence?

Answer: Set a schedule. I also keep a mini pill case in my purse, so if I'm out, I have my meds. Also, don't feel bad if you miss a dose. We already beat ourselves up enough.


Selfie by Martin Hollick and Michael Clark

Martin Hollick and Michael Clark

Hollick is 55 years old, retired, and was diagnosed with HIV in 1990. Clark is 63 years old, retired, and was diagnosed with HIV in 1989. Together for 29 and legally married for 13 years, they live in Norwood, Massachusetts.

Today we only take one pill each. It's easy and effective. In the past, we've taken a lot of stuff, so it's very nice to be down to one pill. But we're still open to the monthly injectable for convenience; we wouldn't have to take the pills every day. It's not that we forget; we have it built into our days. But it would be nice to not have to do it. Getting the prescription refills every month is annoying. We have to time out when we're going to run out and get the new supply ahead of time. So, why not just get a shot? The only thing is that we travel for up to six weeks and you have to get the injectable every month.

Bonus Question: What's your advice for the newly diagnosed?

Answer: Life with HIV today is not that bad. In the '90s, when we had to take some meds on a full stomach and some on an empty one, you had to work out when you were going to eat all day.