Your Essential Guide to HIV Therapy

The 7 Most Frequently Asked Questions

Odefsey (rilpivirine + tenofovir AF + emtricitabine). Photo courtesy Gilead Sciences

While recent advances in antiretroviral therapy have been nothing short of astonishing—affording people with HIV near-normal life expectancy—there remains a dismaying gap in care among those most in need. In fact, of the nearly 1.2 million Americans living with HIV today, fewer than one in four are able to achieve sustained viral suppression key to treatment success.

And this is a problem. Without the means to achieve viral control, individuals with HIV are at greater risk of treatment failure, of developing multi-drug resistance, of getting both HIV- and non-HIV-related illnesses, and of passing the virus on to others.

HIV treatment today is ultimately about more than just taking pills. It's about finding the tools to effectively manage your disease in partnership with your doctor or clinic. It's about starting therapy early to avoid illnesses and treatment complications. It's about keeping yourself linked to care so that you can remain healthy over the long term.

It's about taking charge and normalizing HIV in your life so that you control your disease rather than your disease controlling you.

It all starts with education and by asking yourself the right questions.

1. What Are Antiretrovirals and How Do They Work?

There is no doubt that the drugs used for the treatment of HIV have advanced incredibly over the past 20 year. To appreciate just how effective they've become—and why it's important to start therapy from the moment you're diagnoses—you should first understand how antiretrovirals work, why they work, and how their efficacy can be compromised if they are not taken correctly.

2. When Should I Start Therapy?

On September 30, 2015, the World Health Organization (WHO) revised its global HIV treatment guidelines to recommend the immediate initiation of antiretroviral therapy at the time of diagnosis, irrespective of CD4 count, disease stage or geographic location. Learn why the decision was made and how the Strategic Timing of Antiretroviral Treatment (START) study transformed the way we treat HIV around the world.

3. What HIV Drugs Should I Start With?

The U.S. Department of Health and Human Services recently updated their HIV treatment guidelines, recommending not only the immediate implementation of therapy in all adults living with HIV but prioritizing newer classes for drugs in first-line therapy. Learn why these changes were made and what they mean to you.

4. What Drugs Are Approved for HIV Therapy?

Today, of the five classes of antiretroviral drugs approved for therapy, there are 27 individual agents and 12 fixed dose combination drugs comprised of two or more drug molecules. Learn more about these medications and how they are used in this easy-to-understand chart.

5. What Happens If A Treatment Fails?

Sometimes a treatment fails because of intolerable drug side effect. At other times, it is a result of a virologic or immunologic failure, whereby your drugs are either unable to suppress the viral population in your body or unable to reconstitute immune function. When this happens, evaluations are performed to determine which new treatment will achieve the optimal therapeutic goals for you as an individual.

Learn why treatment failure occurs and what therapies are currently recommended in the event of a failure.

6. How Much Adherence Is Enough?

As a rule, it has long been recommended that patients maintain near-perfect drug adherence (greater than 95%) in order to achieve the complete, sustained viral suppression. In doing so, the risk of drug resistance is minimized, while the effectiveness of the drugs themselves is prolonged. But what happens if doses are missed or treatment is temporarily interrupted? Does that mean the treatment failure is all but inevitable? Learn what the new research actually tells us, and why it's more important than ever to understand the relationship between treatment adherence and treatment efficacy. 

7. Any Tips for Improving Drug Adherence?

Adherence is the one area of HIV management for which you are fully in charge; where you have absolute autonomy over the direction your health and well-being takes. By contrast, suboptimal adherence is one of the main causes of treatment failure, resulting in fewer and fewer drug options. Here are 18 simple (and clever) tips for achieving maximal drug adherence, presented in informative step-by-step gallery.  

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