Once you and your doctor have decided that you should start taking drugs for HIV, your doctor will come up with a personal treatment plan for you. You will find it easier to understand your plan if you learn about the different drugs available and what they do.
Some people chose to start anti-HIV medicines (antiretrovirals, or ARVs) as part of a study or clinical trial. A study may be evaluating a new HIV medicine that is not yet approved by the U.S. Food and Drug Administration (FDA), or a new combination of medicines or treatment strategies targeted to a specific population. If you are interested in learning more about starting ARV treatment as part of a study, talk to your provider about studies that are available in your area and that might be a good fit for you. More information about participating in clinical trials can be found in the section After You Start Therapy. There are many websites that catalogue available clinical trials; one of the most comprehensive is www.clinicaltrials.gov.
| Which drugs should you take?|
Now that you have learned a little about the types of drugs that are available and how they work, you may be wondering how your health care provider will know which medicines you should take.
Anti-HIV drugs are used in combination with one another in order to get the best results. The goal is to get the viral load as low as possible (to levels that are undetectable by standard laboratory tests) for as long as possible.
Anti-HIV medicines do different things to the virus--they attack it in different ways--so using the different drugs in combination works better than using just one by itself. Combinations usually include three antiretroviral drugs. Except in very special circumstances, anti-HIV drugs should never be used one or two at a time. Using only one or two drugs at a time can fail to control the viral load and let the virus adapt (or become resistant) to the drug. Once the virus adapts to a drug, the drug won't work as well against the virus, and maybe it won't work at all.
There is no one combination of HIV medications that works best for everyone. Each combination has its pluses and minuses.
When drugs are used together, the therapy is called combination therapy (or antiretroviral therapy (ART), or highly active antiretroviral therapy (HAART)).
| Combination therapy |
So, how will your doctor know which combination to choose? You and your doctor can consider the options, keeping certain things in mind, such as possible side effects, the number of pills you'll need to take, and how the drugs interact with each other and with other medications you may take.
| Why is it important not to miss doses? |
"Adherence" refers to how well you stay on your treatment plan--whether you take your medications exactly as your health care provider tells you.
If you follow your doctor's instructions about how to take your medicine, the anti-HIV drugs will work well to lower the amount of virus in your blood. Taking your drugs correctly increases your likelihood of success.
But, if you miss doses, or don't follow a regular schedule, the level of the drug in your body goes up and down. The virus then has the opportunity to make copies of itself more rapidly. That increases your viral load.
Following your treatment schedule also helps to prevent drug resistance. If you miss a dose, the virus may make new and different types of itself that the drug can no longer combat.
It's challenging for some patients to stick to their HIV drug treatment plan. Most plans involve taking several pills every day, and some of the drugs have unpleasant side effects.