What you need to know about long-term HIV treatment

Whether you’ve recently started your ART or have been taking a medication for several years, it’s important to take it as prescribed by your doctor to best manage your HIV.

As with other medicines, you may have questions around its effects on your health over time. Click on a question below to find out more about ART, and don’t forget it’s important to talk to your doctor about any concerns you may have.    

  • You’ve likely heard of becoming ‘undetectable’ when reading about ART. This means the amount of virus in your blood (which your doctors may call ‘viral load’) is so low that blood tests cannot detect it. If people have undetectable levels for at least 6 months, research has shown there is no risk of passing on HIV to your partner through sexual contact.Also, your health risks are much less compared to not being on treatment.2  To have the best opportunity to get undetectable viral loads you need to take your ART as prescribed and have your viral load checked on a regular basis.    

  • Most ARTs suppress the virus by stopping it from multiplying within the blood. If you don’t take your medication regularly or you skip doses, this suppression is not as effective. That can lead to viral loads becoming detectable in routine tests.2 It may also increase your risk of developing permanent resistance to some types of ART. This means that as the HIV multiplies, it sometimes produces a different variation of itself that your ART can no longer suppress. This may reduce the number of treatment options available to you.2 You can learn more about different ARTs here

  • No, of course not! It may feel like it’s all on ‘you’ when your medication doesn’t feel right, but research has shown that taking ART regularly can be a problem for lots of different people and situations.HIV treatment guidelines have identified that in some people the following can affect taking medication:

    • Stigma
    • Age-related challenges, such as taking lots of medications for other conditions
    • Active substance abuse
    • Difficulty attending appointments or talking to doctors
    • Side effects
       

    If you are having difficulty taking your ART as prescribed, talk to your doctor about your concerns. Why not also get in touch with your local support groups? Hiv Vereniging https://www.hivvereniging.nl/

  • Research into ARTs used over a long period of time (from less than 2 years to over 8 years) has not been shown to increase the risk of AIDS and non-AIDS related deaths.3 This means the medications were not thought to increase the risk of dying from causes attributed to HIV and AIDS, or other conditions. The study involved over 12,000 people taking the medications over different periods of time, ranging from less than 1 year to 10 years or longer.3 The study also showed a significant decrease in AIDS and non-AIDS related deaths following 2 years of taking ART.3

    ART may also cause side effects in some people called ‘toxic side effects’, which your doctor may call ‘ART toxicity’. These side effects are due to the drug itself, rather than the body reacting to it in a negative way e.g. an allergy. You can read more about toxic side effects here.

  • Sometimes taking two or more medications together can affect how one or more of the medications work. This is known as a ‘drug interaction’ and can sometimes cause side effects. If ART interacts with another medicine it may not work correctly and may increase the risk of resistance developing.4

    If you take more than one medication, it’s important to talk to your doctor and/or pharmacist. Let them know about all your medications. This could include prescription medicines for other conditions, or over the counter products suchs as antihistamines, vitamin supplements or herbal remedies. You should also let your doctor and/or pharmacist know about any recreational drugs you may take.4

Have you seen George and Somchai’s video?

George is 93-years-old and living with HIV. Watch his story on living with HIV and how his treatment has changed from 20 tablets a day to just 2.

  1. Rodger AJ et al. Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy. JAMA. 2016;316(2):171–181. doi:10.1001/jama.2016.5148.
  2. Schaecher KL. The Importance of Treatment Adherence in HIV. Am J Manag Care. 2013; 19 (12 suppl):S231-S237.
  3. Kowalska JD et al. Long-term exposure to combination antiretroviral therapy and risk of death from specific causes: no evidence for any previously unidentified increased risk due to antiretroviral therapy. AIDS. 2012, 28;26(3):315-23.
  4. Terrence Higgins Trust. HIV treatment and other drugs. Available at: Hhttp://www.tht.org.uk/myhiv/HIV-and-you/Your-treatment/HIV-treatment-and-other-drugs