HIV Treatment

If you are diagnosed HIV+, medication will be a very important part of your life if you want to keep the virus under control. It is a life long commitment and you will have to make some lifestyle changes. This section gives an overall explanation of the medications, the virus, what to expect, what to do and what not to do. You should talk to your doctor if you have further questions.

What is HAART?
HAART stands for Highly Active Anti-Retroviral Therapy and it is the current treatment for HIV+ people which helps to promote and prolong a healthier life. It’s combination of at least three different anti-retroviral medications. A cocktail of medications.

Why 3 different medications?
To date, there is no single medication developed to do the job well. Research shows that a combination of medications works better than one.

What are these 3 different types of medications?
It can be divided into 3 groups:
1. Nucleoside Reverse Transcriptase Inhibitor – NRTI
2. Non-Nucleoside Reverse Transcriptase Inhibitor – NNRTI
3. Protease Inhibitors –PI

What does each medication do?
1. NRTI acts like broken building blocks so that the HIV that multiplies in your T-cells are built on broken blocks, hence making the HIV weaker.
2. NNRTI gives wrong instructions to HIV during the building process so their building is weak and can collapse.
3. PI acts like workers putting defective parts in each new virus being built, again to make the HIV weaker.

What happens if I don’t take the medications?
You CD4 cell count will go down which means your immune system will be weakened and you’ll be more prone to falling ill. And the number of HIV (viral load) in your body will increase.

What is viral load?
Viral load tells you and your doctor how much HIV is in your blood. The higher the viral load, the faster you CD4 cells will be destroyed. Hence you will have less CD4 cells. And your immune system gets weaker.

Why is viral load so important?
If you are on HAART, viral load tells you how well the HIV medications are working. If you are not on HAART, viral load may give you an idea about how fast your infection is progressing.

What is the level of viral load I should have?
If you are on HAART, a good level is fewer than 50 copies/ml, i.e. your doctor will tell you that your viral load is at an ‘undetectable’ level.

If I come under ‘undetectable’ levels, can I still transmit HIV?
Yes, Viral load only measures the amount of virus in your blood.

Does HAART help to keep viral load low and CD4 cell count high?
Yes. That is the aim of treatment.

How long do I have to stay on treatment?
Once you start, you can’t quit. So, it’s lifelong. If you stop taking the medications, the virus will start replicating again. It becomes much stronger and hence more difficult to keep the virus under control.

Why should I change my lifestyle before treatment?
Well, because HIV medication is a lifelong commitment and it needs you to make quite a few changes to the way you live, work and play. Starting early just means you get used to your new way of life.

What are the changes that I have to make in my life?
For a start, eat well, exercise. If you smoke, drink or take illicit drugs, try to quit.

Why?
Cigarettes, alcohol and illicit drugs are known to be harmful to our body. Your weakened immune system might not be able to cope with these harmful effects.

Why talk to doctor before starting treatment is so important?
It’s important to have a good and comfortable relationship built on mutual trust with your doctor, because it will be lifelong contact. You may have many questions about HIV, the treatment, side effects and lifestyle changes that you may want to discuss with your doctor. And you must be comfortable doing this.

What should I discuss with my doctor?
How treatment could change your life. How to get ready mentally, emotionally and physically because treatment will be a central part of your life. It will be a commitment you make for life.

What if I can’t take my medications on time?
It may cause your 1st combination of medications to fail. And it makes it harder to keep the virus under control with other combinations.

How many types of combinations are there?
There are only a few types of combinations. So, you do not have many options. That’s why it’s important for you to make the 1st combination work for as long as you can.

What should I consider when deciding on the medications with my doctor?
Keep it simple as it could change your life. Consider all the following:
· The cost of the medications.
· The possible side effects.
· You’ll have to be aware of the medication times, your schedule and changes in your routine.
· You may have to take the medications around meals, with or without certain foods.
· You might have to take your medications with you all the time.
· You may be busy, depressed or lazy but the medications have to be taken on time, every time, every day, every year.
Talk to your doctor about this.
· How many pills do you have to take? It can vary from 3 to 10 pills.
· Do you travel a lot?
· Do the medications need refrigeration and if so, will it be a problem for you?
· Is your work schedule busy that it’s hard to eat your meals regularly?

Are there side effects to the medications?
Yes. All medications, even basic ones have side effects.

Do all HIV+ people experience the same side effects?
No. Some don’t and others vary from mild to severe. Because it’s important to give your 1st combination of medications the best possible chance, talk to your doctor about the possible side effects of the combination you’re deciding on. This will help you decide if you can manage it or not.

Can I take the same medications as my friend?
No. What works for 1 person may not work for another.

Who can I go to for help?
Friends, family and support groups can help you keep to your treatment plan. Check the list given.

Can I change the medications if the side effects are unbearable?
Yes, but talk to your doctor first.

What are the other reasons to change the medications?
Sometimes, combinations are changed if you can’t meet the dosing times or if there are changes to your CD4 cell count and viral load.
Tips to help you take your medications on time:
· Take your medications at the same time every day.
· Keep supplies of your medications at places you go to regularly eg: office, partners, friends or parents’ home.
· Take your medications with you wherever you go.
· Be mindful of the different time zones when traveling.
· Keep a diary or calendar so you can tick off each time you’ve taken your medications.
· Set a timer on you hand phone or alarm clock to remind you.
· Ask your loved ones to remind you.
· If you’re going away for a long period, take ample supplies of your medications.
· Keep a list of medications and the dosage you are on when traveling.
· If you’re a Muslim on treatment, and planning to fast, discuss this with your doctor.

What happens if I miss doses or stop taking my medications?
If you miss doses regularly or stop taking your medications for a few days, you give the virus a chance to escape the control of the medications. This will allow the virus to develop resistance to the medications.

What is resistance?
When the virus develops resistance to the medications, the medications become less effective. If this happens, HIV can multiply in spite of the medications being present.

What can I do to prevent resistance?
Take your medications as ordered by the doctor, strictly on time and take the correct number of pills – not more, not less. This means that the medications are always there to fight the virus.

What if I miss a dose? Can I double it the next time?
No. You may have more side effects and not fight the virus with a double dose. You just need to resume you original dosing time. Also inform your doctor about this on your next visit. You must also make sure that you don’t miss any doses in the future.