It is recommended that everyone living with HIV be on HIV treatment. Because of the highly beneficial results of therapy, there is a movement towards Rapid Start—putting newly diagnosed individuals on treatment within seven days, even on the same day if they are ready. To that end, free HIV medication or a coupon for it may be available in the clinic. Rapid Start bottles or blister packs are provided by pharmaceutical companies. Treatment today is relatively easy. Most newly diagnosed people are put on a one-pill, once-daily drug (single-tablet regimen, or STR). Do not hesitate to call your provider with questions or concerns. Your pharmacist can help too. When diagnosed, individuals should be tested for other sexually transmitted infections (STIs) and hepatitis B and C; receive appropriate vaccinations; and be given a drug resistance test
Know the score
Treatment success is primarily measured by two numbers: 1) increases in the CD4+ T cell count and 2) decreases in the HIV viral load. Viral load, or the amount of virus in the blood, should decrease to less than 50. That is called undetectable viral load. The T cell count is a measure of immune function and the viral load is a measure of viral function. Generally, the viral load is given greater weight.
Sticking with it
Adherence means taking treatment the way it’s supposed to be taken, for example, with or without food and especially not skipping doses. Treatment maintains good health and stops HIV from progressing to AIDS, which can involve life-threatening complications. Free apps are available to remind you to take your pill and to help you track your progress.
Treatment as prevention (TasP)
Another benefit of treatment is prevention: by suppressing your viral load (to less than 200) for at least six months, you cannot pass on the virus. This is called Treatment as Prevention, or TasP, and is also known as U=U (Undetectable Equals Untransmittable). Yes, you can prevent transmission of HIV even in condomless anal sex.
Living with HIV today
HIV is now a chronic medical condition. With treatment, individuals who are more recently diagnosed can expect to live a normal and healthy life span. That said, stigma and socioeconomic inequalities continue to devastate individuals and communities most vulnerable to HIV. Stigma can keep people from protecting themselves against HIV and from finding support after acquiring it, and the benefits of HIV care and treatment are not so easily accessible to all.
Where to find more info
U.S. guidelines for HIV treatment are available from the Department of Health and Human Services (DHHS). Perinatal and pediatric guidelines are also available. Go to aidsinfo.nih.gov. HIV is a relatively new, and complicated, medical condition. Look for an HIV specialist. The American Academy of HIV Medicine and the HIV Medicine Association each have a provider finder. Go to hivma.org and aahivm.org. Individuals without insurance can go to healthcare.gov, or call (800) 318-2596. Each state runs its own AIDS Drug Assistance Program (ADAP), providing free medication for people without insurance, and assistance with co-pays and premiums for those with insurance who qualify. Get help signing up from an AIDS service organization (ASO). Go to adap.directory. Read more about HIV treatment and drugs in the POSITIVELY AWARE HIV Drug Guide. The drug guide includes therapies expected to be approved soon and financial assistance information for co-pays and other drug costs. Go to positivelyaware.com/subscribe.
Taking care of yourself
Telling others can bring much-needed support, or rejection. And once told, it can’t be untold. And yet, disclosure can be empowering. Self-care is important: A hot bath, a good book, a nice walk, or a nap. Creative outlets can quiet the mind and bring a sense of peace: Artwork, adult coloring books, crafts, carpentry, or anything else you love to do. Exercise is a good outlet for stress. Deep breathing is calming. Just one or two deep breaths can help relax the body and mind.
You’re not in this alone
U=U (Undetectable Equals Untransmittable) means that individuals cannot transmit HIV while on suppressive therapy. Go to preventionaccess.org.
The Sero Project works to educate individuals on HIV criminalization laws and to change those laws. The project holds a biannual HIV Is Not A Crime Training Academy. Go to seroproject.com. The Positive Women’s Network–USA is an organization of women living with HIV and their allies that develops a leadership pipeline and policy agenda. Go to pwn-usa.org. The National Center for HIV Law and Policy protects human rights and covers several areas of concern (such as employment, housing, and immigration). Write the center: 65 Broadway, Suite 832, New York, NY 10006. Call (212) 430-6733. Go to hivlawandpolicy.org. People living with HIV are protected under the Americans with Disabilities Act (ADA). Go to ada.gov/archive/hivqanda.txt.
PrEP or PEP?
Certain HIV drugs can also be taken by HIV-negative individuals to avoid infection. There are two available methods: pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). PEP must be started within 72 hours after exposure to HIV and taken for 28 days. PrEP is one pill taken once daily.