30 November 16

Ending HIV

HIV Treatment – what are my options?

If you have recently been diagnosed with HIV, a lot of questions, concerns and fears can go through your mind. Let’s take a look at some of them, and bring you up to date on what HIV treatment can do for you in regard to ensuring your ongoing health and wellbeing.

I’ve become HIV positive and I don’t know what to do. 

This bit of news can be a lot to take in. But the main things to remember are that you are not alone, and that HIV is manageable. People with HIV live happy, healthy and productive lives. And their life expectancy can be as long as someone who doesn’t have HIV. If not longer!

I’ve got so many questions and concerns. I don’t know where to start.

Whoever supplies your diagnosis, whether it be your doctor or sexual health practitioner, they will inform you of the variety of services and resources available to you. You can find more information on support and assistance here. You’re bound to have lots of questions, so don’t be afraid to ask. Everyone is here to help you!

Your doctor or specialist will also talk to you about starting HIV treatment as soon as possible. Known as antiretroviral therapy (ART), this is a medicinal program intended to keep your immune system healthy and suppress the virus from replicating in your body.

Why should I start so soon?

Studies show that early, HIV treatment (as soon as possible after diagnosis) increases health and life expectancy, and reduces the risk of serious illness including cancer, heart, renal and liver disease. All the scientific studies to date indicate that delaying HIV treatment results in poorer health, both in the short and long-term. There are few, if any, negative impacts on your health if you decide to start now or as soon as possible.

It’s important to remember that your viral load (the amount of HIV in your body) is very high when you initially become positive, which can increase the risk of passing it on to another person. So starting HIV treatment as soon as possible can minimise this.

So I’m going to have to take lots of pills for the rest of my life now?

That might have been the case a few years back, but not anymore. HIV treatment generally takes the form of one or maybe three pills a day, and it’s easy to incorporate into your everyday routine. Like brushing your teeth!

But I’ve heard those pills have all these side effects and make you sick.

Many different drugs were trialed when HIV and AIDS first appeared. Some had serious side effects and were quite toxic. But medications have changed, and people on HIV treatment experience little or no side effects. If they do happen, they tend to be temporary and your doctor can help you manage them. It’s all about finding the treatment which works best for you.

And I’ve heard they’re expensive too.

HIV medications are government subsidised for those who hold a Medicare card, so you will only need to pay a small co-payment towards their cost. In NSW the government absorbs this co-payment, so your HIV drugs will cost you nothing. In other states there are also other support schemes available that can reduce this cost even further. Speak to your doctor about them.

Where do I get them from?

Once you and your doctor work out the best program for you, you can get your treatments from your local chemist like any other prescribed medication. There is even an option to purchase them online — go here for more information on this service.

So I just take my pills and everything will be fine?

Put simply, absolutely! As with any chronic illness, you should monitor your progress with your doctor on a regular basis to ensure that your treatment is working effectively. Sometimes your doctor will make changes in both your HIV medicines and other treatments for a range of reasons, including prescribing HIV drugs to manage your particular strain of HIV or to reduce interactions with other medicines.

Does my viral load stay the same once I’m on treatment?
It’s not uncommon for your viral load to fluctuate. Having another illness like the ‘flu, an STI, or missing doses of your HIV treatment can cause this to happen. This is why it’s very important to have regular checks with your doctor — about every three to four months — and take your medication strictly as prescribed. We call this adherence. If you stick to this routine, you can lower your viral load to virtually undetectable levels within a few weeks or months.

So does this mean I’ll eventually get rid of my HIV if I keep taking my meds?

No. ‘Undetectable’ means that the amount of virus has been suppressed to the point where it is too low to be detected by standard measurement. It does not mean that you’re cured or free of HIV – it means that treatment has stopped the virus from replicating, making it far less likely to be passed on during unprotected sex.

When I have an undetectable viral load, is condomless sex safe for my partners? 

Those with an undetectable viral load have negligible risk of transmitting HIV during anal sex. Though it is not possible to say that there is no risk, it is less than the risk presented when using condoms, which can break, come off or not be put on in the heat of the moment.

To continue to keep yourself safe from infecting others, you must ensure that you have the best possible adherence.

What should I do now?

Congratulate yourself! You’re on your way to taking control of your status and your health. Speak to your doctor or sexual health specialist about your treatment options, and together you will find a treatment strategy that works for you. And don’t forget that there are many support services to assist you if you have any more questions or concerns. Read more about how you can access treatment here.

And be well!