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Starting medication & adherence

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Starting medication & adherence

HIV medication works. Effective antiretroviral treatment was introduced in 1996. Before that an HIV diagnosis was for most people a death sentence.

1995 Mortality rate 98%
1996 Medication introduced
1997 Mortality rate 2%
2017 Mortality rate – less than .01%

At first, you had to take many pills – day and night.- and there were considerable side effects.

So when to start?

Increasingly you start medication as soon as possible since there is substantial evidence that starting earlier is better and reduces damage to the immune system.

The guidelines suggest starting medication

  • when the CD4 is consistently around 350
  • someone has a viral load consistently above 100,000
  • treatment as prevention – in order to protect partners
  • Medication can also be taken by HIV negative partners as prevention

Are there side effects?

Most patients experience NO side effects

Depending on the individual, side effects can occur for a short period of time after starting the medication. These can include: nausea or vomiting, drowsiness, lethargy, headaches, dizziness, disorientation or abdominal discomfort.

Severe side effects like lipodystrophy are virtually unheard of.

It usually takes between 1 to 3 months for your viral load to become undetectable.

Adherence – when and how do I take the medication?

  • Some medication is taken in the morning, others in the evening.
  • Your doctor will take into consideration your lifestyle when prescribing.
  • Medication should be taken at set times daily
  • HIV is a very mutational virus and can build resistance if medication is not taken properly.
  • Over 90% adherence is required to avoid resistance
  • Resistance reduces the options for successful medication
  • You are automatically given a resistance test when diagnosed
  • Medication will currently need to be taken for the foreseeable future

If you are having difficulty taking your medication, swallowing your medication or sticking to your specific times, please talk to you doctor, nurse, health advisor or patient representative.

We are glad to say that 98% of Bloomsbury patients take their medication properly and are undetectable.

For more information use the NAM web-site

For clinical guideline go to the British HIV Association (BHIVA) web-site

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