Below are tips to help you and your care providers make empowered, informed treatment decisions. Medications included in the 2020 HIV Drug Guide are those most commonly used, or expected to be approved in the coming year.
With so many choices out there, we order the drug pages by those that are the best options and list them first, followed by commonly prescribed drugs in each category. To quickly find your drug, go to the next page. On the pullout chart, drugs are listed by category and then alphabetically. Older drugs that are rarely used are only pictured (without dosing information) at the bottom of the pullout chart.
Goal of HIV therapy
Understanding HIV treatment is the key to success. The goal of therapy is to suppress the virus to an undetectable level (meaning the virus in your blood is so low, it cannot be detected by normal tests). This will keep you healthy, and the sooner you start therapy, the less damage to your immune system so you’ll stay healthier, longer. When you are on effective antiretroviral treatment (ART) and undetectable (less than 200 copies) for at least six months, it also means you can’t transmit HIV to your partner (undetectable equal untransmittable, or U=U). Getting to and staying undetectable means you need to take your medication as prescribed (for example, if it’s with or without food), and not miss doses.
When a drug is in development it’s first given a “generic” or “scientific” name (such as dolutegravir). At medical conferences and in scientific publications you will often see three-character abbreviations used (DTG). Once it’s approved, it’s given its brand name (Tivicay), which most people know it by.
Drug classes, categories, and co-formulations
A fixed-dose combination (FDC) combines two or more drugs in one tablet, such as Prezcobix (darunavir/cobicistat). A single-tablet regimen (STR) is a complete regimen in one pill, such as Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide).
Anti-HIV drugs should always be taken in combination using two or more drug classes (for example, an integrase inhibitor plus two nukes). Single-tablet regimens (STRs) are not a drug class but combine multiple classes of drugs into one tablet. STRs are widely used for first-time treatment and for their convenience, but they are not for everybody, including some people who are treatment-experienced or have multi-drug resistance.
Recommendations for use
The Department of Health and Human Services (DHHS) and the International AIDS Society-USA (IAS-USA) both publish recommendations for the use of HIV antiretroviral drugs. We include information on some of the recommendations on page 60, and at the top of each drug page, as well as in the pullout drug chart. DHHS and IAS-USA guidelines are very similar, but for consistency we reference the DHHS guidelines. For complete guideline
recommendations go to aidsinfo.nih.gov or iasusa.org/resources/guidelines.
Drug pricing and access
The Average Wholesale Price (AWP) is listed on each drug page and is a way to compare costs of drugs. It is not what you would pay if you were to pay the full retail price. In the drug cost-sharing and patient assistance program charts (beginning on page 66) we include information on how to access programs that can help cover all or part of the costs of these medications.
Talking to your doctor
You can play an active role in your health care by talking to your doctor. Clear and honest communication between you and your physician can help you both make smart choices about your health. It’s important to be honest and upfront about your symptoms even if you feel embarrassed or shy. Have an open dialogue with your doctor—ask questions to make sure you understand your diagnosis and treatment.
Here are a few tips that can help you talk to your doctor and make the most of your appointment:
• Write down a list of questions and concerns before your appointment.
• Consider bringing a close friend or family member with you.
• Take notes about what the doctor says, or ask a friend or family member to take notes for you.
• Learn how to access your medical records, so you can keep track of test results, diagnoses, treatments plans, and medications and prepare for your next appointment.
• Ask for the doctor’s contact information and their preferred method
• Remember that nurses and pharmacists are also good sources of information.
More information online
Operated by the National Institutes of Health, AIDSinfo maintains factsheets on each HIV medication at aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/21/58/fda-approved-hiv-medicines. Download iPhone and Android apps that provide drug info, treatment guidelines, and a glossary: aidsinfo.nih.gov/apps. You can find the online version of your medication’s drug page from our HIV Drug Guide by adding your drug’s name after typing positivelyaware.com/ into your browser (for example, positivelyaware.com/triumeq). To see if your HIV drug interacts with another medication, both prescription and over-the-counter, go to hiv-druginteractions.org.