The decision to begin HIV treatment is yours. Health care providers can tell you all your options, but they should not decide for you. It’s important to know as much as you can about HIV treatment before you make this big decision. Reading this booklet is a good first step. Calling CATIE toll-free at 1.800.263.1638 and speaking anonymously with an HIV treatment representative is another option. Ask your doctor to explain your blood tests to you so you can understand them and take part in your treatment decisions. Write down important information so you don’t forget it.

The meds

Even though there is no cure for HIV, there are medications (meds) that can help slow down the virus so you can stay healthy longer. Since HIV is a complicated virus, doctors usually give people with HIV a combination of three or more different drugs, called “antiretrovirals,” that attack the virus at different stages. This is called “Highly Active AntiRetroviral Therapy” (HAART, for short), or “combination therapy,” or a “drug cocktail.” These combinations can be hard to take — some pills have to be taken with food, others on an empty stomach, and each at a specific time of day.

Combination therapy should help keep your CD4 cell count high and your viral load low. If your CD4 count falls below 200, your doctor may consider putting you on additional medicines to prevent certain common HIV-related diseases. This is called “prophylaxis.” If your immune system stays weak for a long time, you may get an HIV-related illness anyway, such as pneumonia. Your doctor will then treat you with medications for that illness, which you’ll take along with your combination therapy to fight the HIV.

HIV medicines help your body fight HIV, but they do not protect you from infecting other people with HIV. That’s why it is important to practice safer sex and safer drug use, even if you are taking HIV treatment and don’t feel sick.

Side f/x

Although HIV meds can help you stay healthy for a long time by allowing your immune system to get stronger, it’s not always easy to take them because:

• Some can make you feel sick and tired.
• Some cause side effects such as headaches, nausea, diarrhea or skin rashes.
• Some may make you have intense dreams or nightmares.
• Another side effect is called “fat redistribution.” When this happens, your belly or breasts may get bigger and your arms and legs may get skinnier.

Always tell your doctor about your side effects. Some may only last for a short time, some can be treated, and some may be so serious that your doctor will suggest switching your meds. Your doctor may recommend ways to reduce the side effects. You may not have any side effects at all.

Even when the meds are making you feel better, it’s still important to keep taking them. Make sure you talk with your doctor before you stop taking your treatments.

HIV meds can be hard on your liver, which can make them dangerous for people who also have hepatitis and/or who drink or use drugs. You cannot live without your liver. It breaks down all the substances that enter your body — HIV meds, nutrients, drugs, alcohol, methadone. Many people who drink or use drugs already have liver damage because alcohol and drugs damage your liver, as do hepatitis B and C. A damaged liver complicates HIV treatment. Find out more about this from your doctor.

The HIV medications that your doctor prescribes for you will depend on several things:

• your health and how far your HIV has progressed
• which HIV meds you think your body can handle, in terms of side effects
• which HIV meds you’ve taken before
• what other drugs you use — which is why it’s important to find a doctor with whom you can speak openly about your drug use
• whether or not you are ready to stick to a treatment schedule
• whether the HIV in your body has become drug-resistant (which means it doesn’t respond to certain meds). Your doctor can test for this.

Start HIV treatment only if you believe you are ready to commit to it. If you really don’t feel you can stick to the treatment schedule that your doctor prescribes, ask him or her if there is a simpler treatment option that might work for you. Or maybe you’re not ready to start yet. It is risky to start treatment and then stop it — this could make your HIV drug-resistant. You may feel more ready to start treatment at a later time.