HIV stands for human immunodeficiency virus. Most people get HIV when they have unprotected sex or share needles with someone who has the virus.
The virus attacks and weakens your immune system, which is your body's natural defense against infection. HIV infects certain white blood cells called CD4+ cells. If too many of these cells are destroyed or weakened, your immune system is less able to fight infection and disease.
HIV infection can lead to AIDS (acquired immunodeficiency syndrome). People with AIDS have a very low number of CD4+ cells and get infections and some cancers that rarely occur in healthy people. These can be deadly.
If HIV is diagnosed before it becomes AIDS, medicines can help keep your immune system strong and healthy. With treatment, many people with HIV are able to live long and active lives.
A combination of three or more antiretroviral medicines, called antiretroviral therapy (ART), is the main treatment for HIV. It can slow the rate at which the virus multiplies, prevent AIDS, and keep your immune system healthy.
The goal of treatment is to reduce the amount of virus in your body so that it can no longer be detected in your blood.
There are several medicines that are most often combined to treat HIV. They are sorted into five groups:
The U.S. National Institutes of Health recommend one of the following programs for people who begin treatment for HIV:3
You can now get some of these medicines combined into one pill. So you may take 1 to 4 pills a day. Medicines can help stabilize and increase the number of CD4+ cells in your body. And they can prevent AIDS.
Antiretroviral therapy doesn't cure HIV. But people who take these medicines as prescribed:
For the medicine to work, you need to take it every day. If you can't take your medicine as prescribed and you miss doses, HIV may become resistant to the medicine and harder to treat.
Antiretroviral medicines can have side effects that are sometimes serious. If you have side effects, talk to your doctor about ways to reduce them. You may be able to change the way you take the medicines or change to other medicines that have fewer side effects for you. Most people can find an HIV treatment combination that works for them. Be sure you keep taking your medicines, because they help keep the virus under control and your immune system healthy.
If you can't take your medicine as prescribed and you miss doses, HIV may become resistant to the medicine and harder to treat.
Some side effects, such as nausea, may improve when your body adjusts to the medicines. If you have problems taking your medicines, talk with your doctor. There are medicines you can take to treat the side effects.
Side effects of some antiretroviral medicines may include:
Certain antiretroviral medicines may also cause more serious medical problems, such as a buildup of acid in your blood, and changes in the way your body stores fat and uses sugar.
The U.S. National Institutes of Health (NIH) recommends that people begin treatment for HIV as soon as they know they are infected, especially pregnant women and people who have or are at risk for other health problems (such as hepatitis B).1
|Start antiretroviral medicines||Don't start antiretroviral medicines|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I just found out I have HIV. I was really shocked. My doctor said that starting treatment now may help me stay healthy longer. I'm still worried about taking medicine every day, but these medicines sound like my best hope of living so I can see my daughter grow up and get married."
— Marla, age 30
"I put off taking medicine for HIV for as long as I could, but when my CD4+ cell count dropped to 500, I decided that it was time to start. The medicines made me feel dizzy and sick at the beginning, but they are helping my immune system get stronger. I am feeling a little better every week."
— Ted, age 45
"I know several people who were feeling just fine but started ART and got really sick. Right now, I'm not ready to start taking medicines every single day. I haven't ruled out taking them later on, but for now I'm going to do the best I can to stay healthy and appreciate every day that I'm not sick."
— Greg, age 38
"When the doctor first told me I had HIV, I was pretty low. But I know that the newer medicines have fewer side effects than the older ones, and people are getting treated earlier and earlier. My health is important to me. Taking the medicines can help me stay healthy and may help keep my partner from getting HIV."
— Miguel, age 40
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take antiretroviral medicines
Reasons not to take antiretroviral medicines
I want to do everything I can to avoid getting AIDS and to live a long and healthy life.
I don't want to start taking medicine until I have to.
I'm worried that I might spread HIV to others if I don't treat the infection.
I'm not worried about spreading HIV to others.
I'm not worried about the side effects of treatment.
I don't think I could handle the side effects of treatment.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking antiretroviral medicines
NOT taking antiretroviral medicines
1. Even though I don't have symptoms of HIV, I may still need to take medicine.
2. Antiretroviral medicines can help me stay healthy and prevent AIDS.
3. For the medicine to work, I need to take medicine every day.
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||Peter Shalit, MD, PhD - Internal Medicine|
U.S. Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents (2012). Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Available online: http://aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf.
U.S. Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents (2011). Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Available online: http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf.