Starting and staying on treatment

100 years ago, being diagnosed with HIV was regarded as a death sentence. However, today, with improvements in medicine and research into HIV, medications have been developed that can suppress HIV to barely detectable levels in the blood. This means that, even though you still have the virus, you get to live a long fruitful life – provided you take your medications regularly and at the same time everyday.

Current recommendations are that every person diagnosed with HIV is started immediately on treatment. This is to prevent the virus from multiplying and causing damage to your immune system. However, it is important to be psychologically and mentally prepared before you start these medications. The following steps may help you to start and stay successfully on treatment:

1. Talk to your doctor about the treatment options available for you. Typically, HIV treatment consists of 3 medications that may be combined into 1 or 2 pills to be taken once daily. However this varies depending on the individual and how far HIV has progressed. Some people may need to take more medications in order to keep the virus under control.

2. Risks and Benefits: It is normal to feel worried about the risks or side effects of HIV treatment. Some of these side effects include skin rashes, diarrhea, fat redistribution among the body and even increased insulin resistance. However, most of these side effects go away after about a month, and the benefits far outweigh these risks. Talk to your doctor about what to expect when you start taking the medications, and report any unexpected side effects to your doctor. It may help to talk to someone you know who is on treatment as they may give you tips on how to take your medicines, and encourage you throughout the journey.

3. Viral loads and CD4 counts: Your doctor will request for a baseline test to find out the number of copies of HIV in your blood, known as your viral loads and the strength of your immune system, known as your CD4 counts. These tests help to determine whether your drugs are working and whether the virus is under control. It is expected that your viral loads will drop to undetectable levels, which means that the lab test cannot pick up the number of copies in your blood although the virus is still present in your body. Being undetectable also means that your chances of passing on HIV to another person are close to zero, although it is still important that you practice safe sex with your partner. Your CD4 counts will also rise to enable your body fight off diseases. Thus, if your drugs are working, your Viral loads drop, and your CD4 rises.

4. Compliance: It is important that you take your drugs at the same time everyday. This will allow the levels of the drug in the body to be enough to keep the virus suppressed and prevent it from mutating or changing. If this happens, this is called treatment failure and your drugs may have to be changed. Thus, it is important to take your drugs regularly. Many phone applications can help you do this: Medisafe, Pillboxie and Pill Reminder etc. Alternatively, you can simply set an alarm on your phone to remind you to take your medications regularly. Find someone you trust who can help remind you to take your medications everyday. This could be a family member, or a close trusted friend.

5. Staying stigma-free: You may be living in an area where HIV is still stigmatized heavily. Until you are ready for people to know, choose a safe place to keep your medications. Usually, the best place to keep them is in plain sight! However, always seek help when you feel confused about anything.

You can live a long fruitful life with HIV. Get tested, start treatment, and live long!