HIV Treatment: Keeping It Effective

The key to controlling HIV -and keeping your CD-4 count high and your viral load low-- is to stick PRECISELY to the daily schedule for your medication. If you miss doses or don't take them on a regular schedule, the virus could thrive and mutate so that one or more of the medications becomes ineffective. This is called DRUG RESISTANCE, and signs may include fatigue, nausea, and diarrhea. To keep tabs on how well your medications are working, you will get regular blood tests that measure your viral load and your CD-4 count. If the meds ARE working, the viral load may become very low or almost undetectable. And your CD4 count may be near normal. Another way to make sure your treatment remains effective is to be aware of any side effects that pop up unexpectedly or that are severe. They may signal that your multiple drug cocktail is no longer working, and it may be necessary to try another combination of drugs. Some side effects CAN be sudden AND serious, so it's important to see your doctor as soon as you notice them. Journaling even your minor side effects is a good idea too, so you can discuss at your next appointment. Another important way to protect the effectiveness of your treatment regimen is to make sure that ANY OTHER over-the-counter medications, supplements or drugs you're taking do NOT interfere with your antiretrovirals. Always discuss this with your doctor BEFORE you take anything. A healthy lifestyle, with physical activity, good nutrition, and stress management is also important for keeping your treatment working. For more information on living with HIV see the other videos in this series.

Hormonal birth control can prevent conception, help regulate your menstrual cycle, and ease some PMS symptoms. But if you're HIV positive, some types of anti-HIV medications can also reduce the effectiveness of your birth control pill. For instance, non-nucleoside reverse transcriptase inhibitors--or NRTIs--and protease inhibitors - which are standard components of combination treatments - CAN reduce or eliminate the effectiveness of oral contraceptives, whether it's a progestogen-only pill or a combination estrogen-progestogen pill. This is because the same set of enzymes in the liver that breakdown these anti-HIVdrugs, also quickly deactivates contraceptive pills. But on the other hand, oral contraceptives DO NOT impact THE ACTION OF THE antiretrovirals. So EVEN THOUGH your risk of pregnancy increases, your HIV treatment shouldn't be affected. However, other antiretroviral drugs, such as integrase inhibitors - also standard components of combination treatments -- DO NOT reduce the effectiveness of oral contraceptives.Bottom line: if you are using the birth control pill MAKE SURE you ask your doctor if your particular type of HIV treatment regimen raises your risk of pregnancy. And keep in mind, it's not just oral contraceptives that DON'T mix well with specific anti-HIV drugs; hormonal IUDs, vaginal rings, skin patches and shots MAY NOT be as effective, either. Regardless of the form of birth control you and your doctor decide upon, you should ALWAYS remember to use a condom to reduce chances of transmitting the virus to your partner or of you contracting a new strain of HIV that could make your medication regimen less effective. For more information on living with HIV, watch other videos in this series.

Ever hear the phrase "When one door closes, another one opens?" Starting HIV treatment is like opening yourself up to the possibility of a prolonged, healthy life. Treatment can make the amount of HIV in your blood-also called your viral load -- very low or even undetectable. It will also raise your CD4 count-indicating your immune system is rebounding. Opinions vary about how low your CD-4 count can fall before it's time to start taking antiretroviral medication; however, experts suggest that EARLY TREATMENT is the most effective in the long run.When you do start treatment, your doctor will likely prescribe a cocktail of 3 to 4 antiretroviral medications-called HAART or highly active antiretroviral therapy. Your overall health will impact the SPECIFIC cocktail you're prescribed, as will the existence of any pre-existing conditions, like hepatitis B or C. It's also the time to be HONEST with your doctor about personal issues you have, such as depression or substance abuse. Then you can work together to find solutions -- including ways to make medication affordable. Some initial side effects like nausea, vomiting and headaches CAN make it tough to stick to your treatment in the early days. But many of these side effects are temporary so STICK WITH IT, it will get better. But be sure to alert your doctor to any persistent or severe side effects.To make sure your treatment stays effective, it's CRITICAL that you follow your medication regimen PRECISELY. If you DO happen to miss a dose, take it as soon as you realize. But don't double up, if it's time for your next dose. If you've got questions about what to do, get in touch with your doctor before you take your next dose. For more information about your HIVtreatment, check out other videos in this series.