When is the best time to start treatment?

Going on HIV treatment for the first time can seem scary and overwhelming. There is no right or wrong answer. Working closely with your doctor, you can determine the best time to start. This will largely depend on:

  • Your physical health, including your CD4 count. Treatment is recommended for people with 350 or fewer CD4s and may be offered even earlier, especially for those with other factors like high viral loads, hepatitis B or C or a history of heart disease.
  • Your mental readiness to adhere to a strict daily medication schedule.

Which medications should I take?

A combination or “regimen” of HIV drugs (antiretrovirals) is always used to treat HIV. A typical regimen contains drugs from different classes. These include non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs) and protease inhibitors (PIs).

A drug regimen should be selected based on your needs, including:

  • Effectiveness: Some people have a drug-resistant strain of HIV. Resistance testing can help you select the best meds to use.
  • Convenience: Some drug combos only need to be taken once a day.
  • Side effects: Some people may be more sensitive to certain adverse effects than others.
  • Drug interactions: Some HIV drugs don’t mix well with certain non-HIV medications, including herbal remedies.
  • Other infections or illnesses: People with liver or kidney problems, for example, may need to avoid certain drugs or be monitored closely.

What do I need to know about side effects?

All HIV drugs can have side effects, especially when you first start to take them. Temporary ones can include muddled thinking, vivid dreams, rash, nausea or diarrhea. Longer-term effects include increased lipids (fats) in the blood or liver problems. Talk to your doctor about ways to minimize these adverse effects, including changing medication if necessary. If you’re missing doses or want to stop treatment because of side effects, talk to your doctor immediately.

Can I afford medication?
Many programs in the United States are available to citizens and both documented and undocumented immigrants to help pay for HIV treatment. These include private insurance; public coverage like Medicaid, Medicare and AIDS Drug Assistance Programs (ADAPs); and drug company-sponsored programs to reduce (or eliminate) out-of-pocket costs. Ask your health care provider, case manager or local AIDS service organization for information (to find one, visit directory.poz.com; many of these can also provide translation services.)

Quick Tips
Here’s how to get ready to go on treatment:

  • Make a plan: Before you start HIV treatment, be sure you understand: How many pills of each med are you supposed to take at a time? How many times a day are you supposed to take each med, and when do you take them? What should you do if you forget a dose? What are the possible side effects and drug interactions?
  • Cut costs: HIV treatment is pricey. But there are many programs to help reduce or eliminate drug costs. Check with an AIDS service organization (visit directory.poz.com to find one).
  • Talk to your doc: Are you worried about side effects? Confused by your pharmacy’s instructions? Don’t hesitate to call your doctor for answers and advice. And to avoid harmful interactions, tell your doctor or pharmacist about everything you’re taking, including herbal treatments and recreational drugs.
  • Follow up: Once you start treatment, you and your doctor should check your viral load approximately every three months to make sure your regimen is working against HIV.
  • Learn the basics: Understanding the benefits and risks of HIV treatment may help calm your fears. Learn about your options, including when to start and what drugs to start with. You can find out more about HIV drugs at POZ.com.

Last Reviewed: January 31, 2016