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Treatment for HIV

Although there is no cure for HIV at this time, there are medications used to treat and suppress the virus. Eventually, a person’s viral load can become “undetectable” meaning that the amount of HIV in the blood is so low, that the virus is not detected when tested. Controlling viral load is essential for those with HIV to lead a longer life with fewer HIV-related complications.

Recent research has suggested that those who achieve and maintain an undetectable viral load have virtually no risk of transmitting the virus to an HIV-negative partner. This idea has been referred to as “undetectable = untransmittable” or “U=U”. Therefore, the risk of HIV transmission to an HIV-negative partner can be reduced when an HIV-positive partner is on ART and taking their medications as prescribed.1-3

HIV medications can be separated into different categories called drug classes. Each drug class targets a different point in the HIV life cycle. The main HIV drug classes in order of the life cycle steps they impact include:

  • CCR5 antagonists
  • Post-attachment inhibitors
  • Fusion inhibitors
  • Nucleoside reverse transcriptase inhibitors (NRTIs)
  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
  • Integrase inhibitors
  • Protease inhibitors
  • Pharmacokinetic enhancers4

Treatment with multiple HIV medications from a variety of different drug classes has been shown to be the most effective in helping an individual achieve viral suppression. Using multiple medications or classes of medications to treat HIV is referred to as antiretroviral therapy (ART) or combination antiretroviral therapy (cART).

Prophylaxis (PrEP/PEP)

There are some medications that can be used for the prophylactic treatment of HIV. Prophylaxis or prophylactic treatment for HIV involves taking medications to reduce an individual’s risk of getting the virus. PrEP is for individuals who are currently HIV-negative, but who may be at an increased risk of getting the virus. PEP is used immediately after a potential exposure to HIV has occurred, to prevent an exposed individual from getting infected, and is taken for 28 days.

PrEP

Pre-exposure prophylaxis (PrEP) involves taking a daily pill to prevent the transmission of HIV. PrEP is intended to be used by individuals who may be at an increased risk of getting HIV, including those who have a sexual partner with HIV or injection drug users. PrEP contains the medications tenofovir and emtricitabine, and must be taken consistently each day to maintain its effectiveness.

PEP

PEP (post-exposure prophylaxis) is a combination of medicines given after potential exposure to HIV has occurred. PrEP (pre-exposure prophylaxis) is different from PEP in that PrEP is taken before a potential exposure occurs and on a long-term basis. PEP, on the other hand, is designed to be used in emergency situations only, and after a potential exposure has occurred. PEP involves more medications at higher doses than PrEP, and cannot be used on a regular basis. If you consistently have a higher risk of getting HIV, PrEP is a more beneficial, long-term option.5-8

Complementary and alternative medicine

Complementary and alternative approaches to HIV care have become of increasing interest over the past several years. A complimentary therapy or approach refers to a non-traditional treatment that is used with typical medical treatment options. Alternative therapies are used in place of traditional medical treatment options. Some healthcare providers can create plans of care that are integrative, meaning they incorporate both traditional and non-traditional approaches.9,10 Common complementary and alternative therapies used for HIV include:

  • Yoga
  • Massage
  • Aromatherapy
  • Acupuncture
  • Meditation
  • Visualization
  • Herbal medicines
  • Supplements10

Some complementary or alternative therapies may help give the immune system a boost to help fight HIV, such as physical exercises or supplements, while others may be aimed at improving side-effects of treatment.11,12 Whatever the reason is for pursuing these options, it is always important to consult your healthcare provider before trying any new therapy. There can be dangerous consequences to stopping or changing medications on your own and some therapies, especially supplements or herbs, may impact the way a medication or other treatment impacts the body.

Healthy eating and exercise

Healthy eating and exercise are important components of caring for our bodies. This is especially true when battling a chronic condition like HIV. Eating well and participating in regular physical activity can help boost the immune system, reduce stress, help minimize treatment side effects, and improve mental health, all of which are important in the fight against HIV.13

Written by: Casey Hribar | Last reviewed: September 2019
  1. HIV Treatment: The Basics. United States Department of Health and Human Services: AIDSinfo. https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/21/51/hiv-treatment--the-basics. Published January 15, 2019. Accessed August 10, 2019.
  2. Eisinger RW, Dieffenbach CW, Fauci AS. HIV viral load and transmissibility of HIV infection: Undetectable equals untransmittable. JAMA. 5 Feb 2019; 321(5), 451-452.
  3. The Science is Clear: With HIV, Undetectable Equals Untransmittable. National Institutes of Health: National Institute of Allergy and Infectious Diseases (NIAID). https://www.nih.gov/news-events/news-releases/science-clear-hiv-undetectable-equals-untransmittable. Published January 10, 2019. Accessed August 10, 2019.
  4. FDA-Approved HIV Medicines. United States Department of Health and Human Services: AIDSinfo. https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/21/58/fda-approved-hiv-medicines. Published June 24, 2019. Accessed August 10, 2019.
  5. Effectiveness of Prevention Strategies to Reduce the Risk of Acquiring or Transmitting HIV. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/risk/estimates/preventionstrategies.html. Published March 7, 2017. Accessed August 10, 2019.
  6. HIV/AIDS Prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/prevention.html. Published January 16, 2019. Accessed August 10, 2019.
  7. Pre-Exposure Prophylaxis (PrEP). Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/risk/prep/index.html. Published May 28, 2019. Accessed August 10, 2019.
  8. PEP. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/pep.html. Published July 23, 2018. Accessed August 10, 2019.
  9. Complementary, Alternative, or Integrative Health: What’s in a Name? National Institutes of Health: National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/integrative-health. Published April 2, 2019. Accessed August 10, 2019.
  10. Alternative (Complementary) Therapies for HIV/AIDS: Entire Lesson. U.S. Department of Veterans Affairs. https://www.hiv.va.gov/patient/daily/alternative-therapies/single-page.asp. Published April 30, 2019. Accessed August 10, 2019.
  11. Bahall M. Prevalence, patterns, and perceived value of complementary and alternative medicine among HIV patients: a descriptive study. BMC Complementary and Alternative Medicine. 23 Aug 2017; 17, 422. Available from: https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-017-1928-4. Accessed August 10, 2019.
  12. Lorenc A, Robinson N. A review of the use of complementary and alternative medicine and HIV: Issues for patient care. AIDS Patient Care and STDs. Sep 2013; 27(9), 503-510. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3760022/. Accessed August 10, 2019.
  13. Diet and Nutrition and HIV: Entire Lesson. U.S. Department of Veterans Affairs. https://www.hiv.va.gov/patient/daily/diet/single-page.asp. Published May 2, 2019. Accessed August 10, 2019.