There's no cure for HIV, but treatment options are much better than they were a few decades ago. Because of medical advancements, people can now live long, active lives with HIV.
Before you start treatment, tell your doctor about all of your past health issues and illnesses. Let them know about any alternative or complementary therapies you're using, as well as any supplements or drugs you're taking now: prescription, over-the-counter, and recreational.
Why Get Treated?
When you take it exactly as your doctor prescribes, HIV medication can keep the amount of virus in your blood at a low level. This is called viral suppression. It may even make this “viral load” so low that a test can’t spot any signs of HIV.
When your viral load is undetectable, you can stay healthy and have essentially no risk of passing the virus on to other people.
Taking your medicines as prescribed also helps keep the virus from changing and becoming resistant to the drugs. If this happens, it can limit your treatment options and make you more likely to spread HIV.
ART (Antiretroviral Therapy)
The medicines that treat HIV are called antiretroviral drugs. There are more than two dozen of them, and they fall into nine main types. Each drug fights the virus in your body in a slightly different way.
Research shows that a combination, or "cocktail," of drugs is the best way to control HIV and lower the chances that the virus will become resistant to treatment. Your doctor will probably recommend that you take three medicines from two of the groups. Some options combine three medicines in one pill that you take once a day.
The FDA has also approved a monthly injection of two medications to treat HIV in certain people.
Your Treatment Plan
Your doctor will recommend the treatment that’s best for you, based on things like:
- What strain of the virus you have and whether it’s drug-resistant
- What other medical conditions you have
- What medications you take
- How well your immune system is working
- How many pills you want to take each day
You might also need medicines for health problems caused by or related to your HIV.
Medicines affect everyone differently, so your doctor may need to make changes in your treatment over time. This can also happen if your HIV becomes drug-resistant. Or you might talk to your doctor about joining a clinical trial that’s researching new medicines.
Medication Side Effects
The ART drugs can have side effects, although newer medications usually don't cause as many. You may have some for a short time. They might include:
- Feeling queasy or throwing up
- Diarrhea
- Fatigue
- Dizziness
- Skin rashes
- Trouble sleeping
Often, side effects will go away as your body adjusts to the medication.
If a side effect is bothersome, you may be able to do something about it. Check with your pharmacist or doctor about whether or not you should take your medications on an empty stomach. Let your doctor know you're having trouble. They might prescribe something to help or change your treatment regimen to lessen the impact.
Don't stop taking your ART. That could give HIV a chance to get stronger and do more damage.
Lifestyle Changes and Complementary Treatments
A healthy lifestyle can ease some of the effects of HIV or its treatment:
- Stick to a balanced diet. Energy and nutrients help your body fight HIV. A healthy diet may also let your medications work better and could ease side effects. But be careful to prevent foodborne illness by avoiding raw meat and eggs.
- Get regular exercise. It boosts strength and endurance, lowers your risk of depression, and helps your immune system work better.
- Don’t smoke. Smoking can make you more likely to get a serious condition like cancer, pneumonia, heart disease, or chronic obstructive pulmonary disease (COPD). People with HIV who smoke tend to have shorter lifespans than those who don’t.
- Get your vaccinations. Ask your doctor about whether they recommend that you get vaccines against pneumonia, flu, COVID-19, hepatitis A or B, or HPV.
Some people say that complementary therapies -- those done in addition to standard medical treatment -- help them feel better and live fuller lives with HIV. These may include:
- Ayurvedic medicine. This ancient Indian medical system focuses on living in balance and harmony. Meditation, prayer, baths, massage, and herbal therapies are sometimes involved.
- Homeopathy. Personalized remedies that treat the whole person rather than one illness are at the heart of homeopathy.
- Naturopathy. This practice merges modern knowledge and natural forms of medicine.
- Traditional Chinese medicine (TCM). Acupuncture may be the most popular aspect of TCM, which also includes nutritional and herbal treatments.
- Supplements. Acetyl-L-carnitine, whey protein, amino acids, probiotics, zinc, iron, selenium, and vitamins A, B, C, D, and E may be helpful.
Always talk with your doctor before adding a traditional practice or nutritional supplement to your HIV treatment plan.
Tests
You'll need tests to help your doctor plan your treatment and to see how well it's working. If you change medicines, you will need tests to see how well they work.
A CD4 count tells your doctor how healthy your immune system is. HIV attacks your CD4 cells, and the test checks the number of them you have in a sample of your blood. You'll likely get your CD4 count tested about a month after you start treatment and then every 3 to 6 months.
The viral load is a measure of how much of the HIV virus is in your blood. You'll need to get tested about a month after you start treatment and then depending on what the CD4 count is at the onset of therapy, every 3 to 6 months is reasonable if it is low. If it is greater than 500 and the virus remains undetectable, there may be no need for further testing.
Your doctor will also test you to make sure the strain of HIV you have isn't resistant to any drugs.
Other tests check on your health to help you avoid related illnesses and conditions.
- Blood tests for anemia, blood sugar, and other conditions as well as making sure specific organs and other parts of your body are working right
- Urine tests that check your kidneys
- Cholesterol and triglyceride tests, because HIV and many of the antiretroviral drugs that treat it can raise the levels of these fats
- Sexually transmitted diseases (STDs), such as gonorrhea, syphilis, herpes, and chlamydia
- Infections and diseases such as hepatitis, tuberculosis, and toxoplasmosis
While You’re in Treatment
You’ll need to see your doctor regularly so they can be sure your HIV treatment is working. Let them know if you’re having trouble sticking to your treatment plan, such as if you have problems remembering to take pills or side effects from the medications.
AIDS Treatment
The most severe stage of HIV is acquired immunodeficiency syndrome (AIDS). This is when your immune system is badly damaged, and it’s often marked by certain illnesses called opportunistic infections (OIs). If you get one of these, your doctor will treat it with medications such as antivirals, antibiotics, or antifungals.
Remember, if therapy is started early, the goal is to keep the immune system healthy and never progress to AIDS.
Insurance
If you have health insurance, your insurer may pay for your treatment. If they don't, or you don't have health insurance, you can get coverage through a government program like Medicaid.
Under the Affordable Care Act, insurance companies can't refuse to cover you because you have HIV or AIDS.