HIV Treatment Overview
What Is HIV Treatment?
HIV treatment involves taking highly effective medicines called antiretroviral therapy (ART) that work to control the virus. ART is recommended for everyone with HIV, and people with HIV should start ART as soon as possible after diagnosis, even on that same day.
People on ART take a combination of HIV medicines called an HIV treatment regimen. A person's initial HIV treatment regimen generally includes three HIV medicines from at least two different HIV drug classes that must be taken exactly as prescribed. There are several options that have two or three different HIV medicines combined into a once-daily pill. Long-acting injections of HIV medicine, given every two months, are also available if your health care provider determines that you meet certain requirements.
Why Is HIV Treatment Important?
If taken as prescribed, HIV medicine reduces the amount of HIV in your blood (also called your viral load) to a very low level, which keeps your immune system working and prevents illness. This is called viral suppression, defined as having less than 200 copies of HIV per milliliter of blood.
HIV medicine can also make your viral load so low that a standard lab test can’t detect it. This is called having an undetectable level viral load. Almost everyone who takes HIV medicine as prescribed can achieve an undetectable viral load, usually within 6 months after starting treatment. Many will bring their viral load to an undetectable level quickly, but it could take more time for a small portion of people just starting HIV medicine.
There are important health benefits to getting the viral load as low as possible. People with HIV who know their status, take HIV medicine as prescribed, and get and keep an undetectable viral load can live long and healthy lives.
There is also a major prevention benefit. People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load will not transmit HIV to their HIV-negative partners through sex. Learn more about the prevention benefits of having an undetectable viral load.
HIV treatment is most likely to be successful when you know what to expect and are committed to taking your medicines exactly as prescribed. Working with your health care provider to develop a treatment plan will help you learn more about HIV and manage it effectively.
If left untreated, HIV will attack your immune system and can allow different types of life-threatening infections and cancers to develop. If your immune system is not working well, you are at risk of getting an opportunistic infection. These are infections that don’t normally affect people with healthy immune systems but that can affect people who aren’t on treatment and whose immune systems are weakened by HIV. Your health care provider may prescribe medicines to prevent certain infections.
When Should You Start HIV Treatment?
If you have HIV, it’s important to start treatment with HIV medicine as soon as possible after diagnosis, regardless of how long you’ve had the virus or how healthy you are. HIV medicine slows the progression of HIV and can keep you healthy for many years.
It is especially important for people with HIV who have early HIV infection or an AIDS-defining condition to start HIV medicines right away. (Early HIV infection is the period up to 6 months after infection with HIV.)
People with HIV who become pregnant and are not already taking HIV medicines should also start taking HIV medicines as soon as possible to protect their health and to prevent transmitting HIV to their babies.
If you have been diagnosed with HIV and are not currently taking HIV medicines, talk to a health care provider about the benefits of getting on treatment.
Does HIV Treatment Cause Side Effects?
Like most medicines, HIV medicines can cause side effects in some people. However, not everyone experiences them. The HIV medicines used today have fewer side effects and are less severe than in the past. Side effects can differ for each type of HIV medicine and from person to person. Some side effects can occur once you start a medicine and may only last a few days or weeks. Other side effects can start later and last longer.
Side effects of HIV medicine most commonly reported include:
- Nausea and vomiting
- Difficulty sleeping
- Dry mouth
HIV medicines also may cause different side effects in women than men.
If you experience side effects that are severe or make you want to stop taking your HIV medicine, talk to your health care provider or pharmacist before you miss any doses or stop taking the medication. Skipping doses or starting and stopping HIV medicine can lead to drug resistance, which can harm your health and limit your future treatment options. Your health care provider may prescribe medicines to reduce or eliminate side effects or may recommend changing your HIV medicines to another type that might work better for you. Learn more about possible side effects and ways to manage them.
Do You Need to Keep Taking HIV Treatment?
Yes. ART is not a cure and the virus remains in your body, even when your viral load is undetectable, so you need to keep taking your HIV medicine as prescribed. If you stop taking your HIV medicine, your viral load will quickly go back up.
If you have stopped taking your HIV medicine or are having trouble taking all the doses as prescribed, talk to your health care provider as soon as possible. Your provider can help you get back on track and discuss the best strategies to prevent transmitting HIV to your sexual partners until your viral load is confirmed to be undetectable again.
What Is HIV Drug Resistance?
When HIV isn’t fully controlled by HIV medicine, the virus makes copies of itself at a rapid rate. As HIV multiplies in the body, it sometimes mutates (changes form) and produces new forms of the virus that may not be as sensitive to a particular medicine as the original virus. This is called drug resistance.
With drug resistance, HIV medicines that previously controlled a person’s HIV are no longer effective against new, drug-resistant HIV. In other words, the HIV medicines can't prevent the drug-resistant HIV from multiplying. Drug resistance can cause HIV treatment to fail.
A person can initially be infected with drug-resistant HIV or develop drug-resistant HIV after starting HIV medicines. Drug-resistant HIV also can spread from person to person. Drug-resistance testing identifies which, if any, HIV medicines won’t be effective against your specific strain of HIV. Drug-resistance testing results help determine which HIV medicines to include in an HIV treatment regimen.
Taking your HIV medicine as prescribed helps prevent drug resistance.