Treatment for HIV

There are many options to treat HIV (human immunodeficiency virus), though there is not yet a cure for it. Treatment includes a range of prescription drugs and healthy lifestyle choices that support the body's ability to fight illness.¹

If it is not treated, HIV can lead to AIDS (acquired immunodeficiency syndrome). However, with treatment HIV can become undetectable. This means the amount of virus found in the blood is so low it cannot be found during testing.¹

Viral load refers to how much of a virus you have in your body. A high viral load means your body is not fighting HIV well.²

An undetectable viral load is the goal of HIV treatment because it means the virus cannot be transmitted to another person. An undetectable viral load also helps the person with HIV live a longer life with fewer HIV-related complications.^1,3

An undetectable viral load is so important in HIV treatment that the United States government launched a public campaign to spread the word:³

• U = U stands for undetectable equals untransmittable

With early, consistent treatment, people with HIV can expect to live a normal to near-normal life span.⁴

HIV antiretrovirals (ARVs)

Antiretrovirals (drugs that fight a virus) are the mainstay of HIV treatment and are commonly known as ARVs. There are several types (drug classes) of ARVs used to treat HIV. Each drug class targets a different point in the virus's life cycle. The main HIV drug classes include:⁵

• CCR5 antagonists
• Fusion inhibitors
• Integrase strand transfer inhibitors
• Non-nucleoside reverse transcriptase inhibitors
• Nucleoside reverse transcriptase inhibitors
• Attachment inhibitors
• Protease inhibitors
• Pharmacokinetic enhancers

The virus is controlled best when a person takes multiple types of HIV drugs at the same time. This method of treatment may also be called cART (combination antiretroviral therapy). Most people can get HIV under control within 6 months.^5,6

When should treatment begin?

HIV treatments work best when started as quickly as possible after diagnosis. Everyone with HIV needs treatment, no matter how healthy they are or how long they have had HIV. People with HIV who become pregnant should start taking HIV drugs right away if they are not already on a treatment plan. Taking HIV drugs during pregnancy prevents the virus from transmitting to the baby.⁶

HIV drugs in pill form must be taken every day. People with an undetectable viral load may be given a shot once a month or once every other month.^5,6

Taking HIV drugs consistently helps prevent drug resistance. Drug resistance means the virus can change (mutate) and become harder to treat.^6,7

Common side effects of HIV treatment

Side effects vary from one medicine to another and one person to another. Some side effects occur when you start ARVs and gradually go away. Other side effects may begin later and last longer. Women and men may have different side effects.⁷

Not everyone feels all of the most common side effects of ARVs:^5,7

• Nausea and vomiting
• Diarrhea
• Sleep problems
• Dry mouth
• Headache
• Rash
• Dizziness
• Fatigue

Some people who get shots feel pain temporarily at the injection site. Your doctor can help you manage any side effects you may feel.⁵

Preventing HIV with PrEP and PEP

There are medicines you can take to reduce the risk of getting HIV. These are called PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis). PrEP can be taken long-term. PEP is used in emergency situations only.

PrEP are prescription drugs taken daily. PrEP is recommended for people at risk of getting HIV. This includes people who:

• Are HIV-negative and have a sexual partner with HIV
• Inject drugs

PEP is a combination of drugs taken short-term after a potential exposure to HIV.

Healthy lifestyle choices

Healthy eating and exercise are important parts of HIV treatment. Healthy eating gives your body the energy and nutrients it needs to fight HIV and other health conditions. It also helps your body manage HIV symptoms and complications and better absorb medicine.⁸

Regular exercise offers many benefits too, including:⁸

• Improving strength and endurance
• Reducing the risk of depression
• Improving your mood
• Strengthening your immune system

If you smoke, it is important to try and quit. People with HIV who smoke are more likely to have serious complications, such as: ⁸

• Developing several different kinds of cancer
• Responding less well to HIV treatments
• Developing:
  • Pneumonia
  • Heart disease
  • Chronic obstructive pulmonary disease
  • Having a shorter lifespan

Supplements, home remedies, and stress relief

Many people use home remedies, over-the-counter supplements, and nonmedical practices for their health. You may hear this called complementary and alternative medicine, integrative medicine, or mind and body practices. These practices include a large group of treatment approaches that lie outside mainstream medicine.⁹

Common complementary and alternative therapies include:^9,10

• Yoga
• Massage
• Aromatherapy
• Acupuncture
• Meditation
• Visualization
• Deep breathing
• Herbs
• Supplements like vitamins, minerals, or probiotics

Most people assume herbs and supplements are safe to take. However, people living with HIV must take extra precautions. Always tell your doctor what you are taking. Some natural remedies can interact poorly with your HIV medicine.¹⁰

Complementary treatments should never be used in place of medicines approved by the US Food and Drug Administration.¹⁰

That said, yoga, mindfulness, meditation, and breathing exercises can be useful to help manage stress, depression, and anxiety. Acupuncture may help relieve pain and headaches.⁹

Interested in sharing your own treatment experience, or another aspect of living with HIV?