Anti-HIV treatment has transformed HIV into a manageable, long-term condition that can enable people living with HIV to live longer and healthier lives. HIV medication stops the virus from replicating, decreasing the amount of HIV in the blood. This ensures the impact on your body is minimal and can make the likelihood of passing on the virus very low.

When do I need to start treatment?

Not everyone has to go on treatment as soon as they are diagnosed with HIV. When you start treatment depends on how advanced the infection is and how your body is coping. This is measured by your CD4 count which is a measure of the number of infection fighting cells the body has. The higher your CD4 count the stronger your immune system.

If your CD4 counts get to around 350, you have another health condition or you are over 50 years old, your doctor may talk to you about treatment options. You will probably go for check-ups to monitor your CD4 and viral load to see how well your treatment is working.

Do I really need to take my medication every day?

For your HIV treatment to be successful, you will probably need to take three different drugs, which affect HIV at different stages in its replication. HIV treatments are simpler to take than they used to be and there are options so you can find the combination that’s best for you. The three drugs might come in one or two tablets, making them easier to take.
Once you go on treatment you must take it properly and regularly, this is called adherence. Missing even a few doses a month can mean your treatment doesn’t work as well as it could do, and your HIV may become resistant to those drugs. It’s important to follow your doctor’s instructions about taking your treatments and what to do if you forget.

What about side effects?

It is completely normal for medications to have side effects; you just need to find the ones that work for you. HIV treatments have advanced significantly over the years and some of the more severe side effects are no longer a problem. Most side effects such as nausea, headaches and diarrhoea generally subside within the first few weeks however some may persist. Talking to your doctor will ensure you get the combination right and they will be able to give you some advice for managing your medication. Simple tips such as keeping a diary of any side effects so your doctor can easily see the problems or taking your medication before bed so that you will sleep through the immediate effects can be really effective.
ARVs can also interfere with other prescribed drugs that you can buy over the counter, herbal remedies or recreational drugs. Think about telling your pharmacist or doctor what other medication or drugs you are taking so that you can access the best HIV treatment.

Drug Resistance

Every time HIV reproduces there is a chance it can change in a way that means it is less susceptible to medication. This means the virus will continue to replicate and you may have to change your treatment. At your first specialist appointment, your blood should be tested for resistance, ensuring you’re given the most effective treatment. If you find you are resistant to a particular treatment there are other options. When you start treatment you will be started on more than one kind which makes it harder for HIV to become resistant to one particular type. Ensuring that you always keep up to date with your medication by taking it at the correct times every day means your viral load will be as low as possible, making it more difficult for HIV to mutate and reproduce.

Will I have to pay for my treatment?

Anyone who qualifies for treatment within the NHS will receive free HIV treatment. Scotland has a good record of ensuring all people living with HIV have treatment access. If you have any trouble let us know.

What is treatment as prevention?

Because treatment reduces the amount of virus in the body, the chances of someone living with HIV transmitting HIV to a negative partner are decreased dramatically if they are on anti-HIV medication. In fact, the HPTN study revealed that this risk can actually be decreased up to 96% if the positive partner has an undetectable viral load. This can be important and useful if you are in a relationship with differing HIV status. Talk to your doctor about treatment as prevention or use our service finder for information on where to get advice.

If you are struggling with adherence, side effects or drug resistance there are many places you can go to for support. MyHIV is an online community for people living with HIV or use our service finder.

Try Aidsmap Factsheets for more information on treatments.

Check out Your Story, Your Script a website dedicated to helping people get the best out of anti-HIV treatment.

Your rights

When you attend NHS and other health and social care services, you can expect to be treated in a way that helps to keep you healthy and well.

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