Updated: May 27
Our last discussion on HIV & AIDS awareness is on treatment. There are several different medications used to treat HIV/AIDS. Many are available as once daily treatments, but each regimen is a combination of medications to actively suppress the virus.
Antiretroviral therapies (ART) for HIV have come a long way. Back in 1987, the first drug for HIV, zidovudine, was approved for use. This treatment had a huge impact on controlling the progression of the virus and gave patients with HIV a much more positive outlook on their diagnosis. Though groundbreaking, this treatment doesn’t come without its downsides. Zidovudine requires multiple doses per day and there is potential for serious side effects including severe allergic reactions, muscle, kidney and liver problems, and blood disorders. Zidovudine is still a potential treatment for HIV, but now we have several different options for ART which work in different ways to suppress the virus and get patients to undetectable levels. Many of these treatments are only one or two pill regimens, and most are taken just once a day with relatively manageable side effects. Some of these once daily treatments include Biktarvy, Genvoya, Atripla, and Triumeq. New treatments for HIV are being studied regularly, and just recently, a new once monthly injection called Cabenuva was approved by the FDA in January of 2021. Side effects to ART will vary based on the medication, so consult your doctor or pharmacist for more information. Common side effects typically include fatigue, nausea, diarrhea and headaches but these side effects are often short-lived. Thanks to the antiretroviral treatments we have today, HIV/AIDS is no longer considered a death sentence. Though it is a life-changing diagnosis, compared to the outlook of the condition in the 1980s, patients with HIV/AIDS today can live normal, long, and plentiful lives.
National Institutes of Health. FDA Approval of HIV Medicines. HINinfo.NIH.gov. https://hivinfo.nih.gov/understanding-hiv/infographics/fda
approval-hiv-medicines. Published February 8, 2021. Accessed April 4, 2021.
While on ART, you will likely have your blood drawn every few months to determine how well the therapy is working. This is determined by your viral load and CD4 counts. Your viral load is the amount of HIV in the blood, and CD4 counts are the number of immune cells in your blood. When treating HIV, we aim for a low viral load and a high CD4 count which shows that the medications are properly suppressing the virus’s ability to make copies of itself and therefore preventing the destruction of immune cells. As we have mentioned before, the goal of treatment is for the viral load to be so low that it isn’t detected in lab work, otherwise known as being undetectable. You may even hear the phrase Undetectable = Untransmittable as a slogan to drive home the point that achieving and maintaining an undetectable viral load through proper and consistent use of prescribed antiretroviral therapy means that the virus can’t be transmitted to others through sex. Another similar phrase for this is “treatment as prevention” meaning that those who are HIV positive on ART can prevent transmission to their HIV negative partners.
Let’s discuss one of the most important topics surrounding medications, and that’s adherence. Adherence is a term defining the willingness and the extent to which someone takes a medication as prescribed by their healthcare provider. One way adherence is assessed is by the number of missed doses of medication in a given week or month. Medication adherence is important regardless of the condition being treated but adherence to HIV/AIDS medication is essential for reducing the viral load to undetectable levels. Achieving undetectable levels not only allows for suppression of the virus but it can also prevent the virus from negating the action of the medication (drug resistance), significantly reduce transmission of HIV to others, and delay or prevent progression to AIDS. Simple things you can do to avoid missing doses of medication include setting alarms or calendar events to remind you to take your dose, especially if any of your medications need to be taken multiple times a day. Pill boxes are also an option, but some HIV/AIDS medications must be kept in their original container so talk with your pharmacist about which of your medications can or can’t be kept in a pill box.
Thank you for taking the time to learn more about HIV/AIDS awareness, prevention, and treatment. We hope these mini-series was educational and brings some more light to the complexities of this condition. As a quick public service announcement, if you’re reading this and have never been tested for HIV, consider getting yourself tested. Regardless of the results, know that there are tons of resources on treatment and prevention and a large community of support. Last, but not least, we will end our discussion of HIV/AIDS with a few short personal stories of people with HIV/AIDS.
“I was born with HIV. I was diagnosed at birth in 1990. My chances of survival were incredibly slim. I lived in hospitals the first several years of my life. I’ve been on most HIV treatment regimens. I was constantly educated about HIV but trying to understand it was so hard. Before I was eight, I’d lost both parents to AIDS…. [HIV] doesn’t have to be as crippling as it once was. I exercise, I work, and I take part in anything I find interesting - I live a normal life. I’m resilient. I don’t have to go through what my parents went through. I recall vivid images of their last days and think if only antiretroviral treatment was as advanced then as it is now, they may have lived. Their losses are a whole different story for another day, but I truly find myself a warrior!”
“As a gay man, one of the hardest things you can do is come out. You fear whether or not your family and friends will accept this ‘new’ you and you face the possibility of losing the people that are important in your life. After I came out as gay, the one thing I never thought I would have to do is come out again…but this time, as an HIV-positive man?
Some years back, I went in for a routine blood test…I wanted to get checked because I had just started a new relationship. I wasn’t worried though. Being that young, I felt like I was invincible. I figured I had nothing to worry about. A week later, I received a phone call from my doctor. He asked if I was in a place that I could talk privately. My heartbeat stopped for some seconds. “You tested positive.” I heard his words, but I couldn’t comprehend what he was saying. It wasn’t possible, not me. No, please not me. Emotions took over and I sat down crying and letting the tears wash over my face…I don’t remember much from those days as I have blocked most of it out. There were too many tears, but I do remember the days that followed. I was in and out of an HIV specialist’s office. My viral load was low. To this day, my CD4 count is still high and my viral load is undetectable…. I still go in for my routine therapy every two months and that’s about the only thing that has really changed in my life. My friends still look at me the same and my partner loves me unconditionally and supports me wholeheartedly. I’ve learned that I am not my status, but the man I make myself into every day. I am not just HIV-positive…I am me “
For more personal stories of people living with HIV/AIDS, visit:
About Valeda Rx
Valeda Rx is an independent national specialty pharmacy, servicing all 50 US States and the District of Colombia. We are focused on improving the care for patients living with complex and chronic conditions such as Hepatitis C, HIV, Multiple Sclerosis, Rheumatoid Arthritis, Psoriasis, Crohn's, Oncology Diseases and more. Our Care Team puts patients’ needs first, treating each as though they were part of our own family.
By working together to coordinate the right medication for the right therapy at the right time for our patients, we support and guide the improvement of patient outcomes. Whether you are a patient, caregiver, prescriber or partner, you will receive the type of independent care and attention and service you not only need, but that you also deserve.