So on to the first big question—when to start treatment. Since useful drugs have become available, many doctors have gotten very excited about HIV treatment, and they often recommend that treatment begin as soon as possible. This may be the right option for you, but it's usually worth taking your time to learn about the drugs before you make a decision about starting treatment. Sometimes HIV-positive people can be healthy and stable for a long time without medication. In the US government's guidelines on HIV treatment, the most important instruction about starting treatment is often overlooked: treatment should begin when you are ready.
For an overview of when experts recommend starting treatment and which antiretrovirals to use first, click on the following lesson link:
While the new drug combinations are much more effective than the few drugs that were used in the early days of the epidemic, they're not perfect. You may at some point have to consider switching the drugs in your treatment regimen because of side effects, drug interactions, or just because they're not working. Deciding whether to switch or not, and which drugs to switch to, can be very complicated. The factors that go into making these decisions have not been fully researched, so once again, don't rush it. Do your homework, ask a lot of questions, and change your treatments only when you are ready.
For more on when to change your treatments and which drugs to switch to, click on the following lesson link:
Some incredibly useful tests are available to help you and your health care provider decide which medications you should switch to if drug resistance is preventing your current regimen from working effectively. In fact, drug-resistance testing is recommended for all HIV-positive people, soon after they're diagnosed, to see if they were infected with a drug-resistant strain of HIV (which may prevent the use of certain drugs when the time comes to begin treatment). To learn more about HIV drug resistance and drug-resistance testing, click on the following lesson link:
Fortunately, new drugs are still being developed to treat HIV. Studies of these drugs are known as clinical trials. There may be benefits of participation in a clinical trial, including access to a promising new drug which could be more powerful than current treatments, has fewer side effects or is easier to take. On the other hand, there could be risks: usually, scientists do not know how powerful new medicines are, or what their side effects may be. Therefore, participants in clinical trials are risking getting assigned to inferior treatments. Entering a clinical trial is sometimes the best decision, but it's one that you should think carefully about before you do it.
For a discussion of the pros & cons about participating in clinical trials, click on the following lesson link:
Regardless of whether you're being treated by your personal healthcare provider or participating in a clinical trial, it is important to remember that antiretroviral therapy is a partnership. Just as you rely on your antiretrovirals to be proven safe and effective, your medications don't work alone—you need to take them correctly if they are to keep you healthy. This is called "treatment adherence." To learn more about treatment adherence, including what it means, why it's so important, some of the issues that can get in the way of good adherence, and ways to overcome these obstacles, check out the following lesson:
Making a long-term commitment to continue HIV treatment, especially with such strict adherence requirements, may be easier said than done. There are occasions in which treatment needs to be stopped temporarily, and there are important issues to remember when doing this. Even if treatment interruptions aren't necessary, they may be desirable, given that HIV treatment can cause long-term side effects, can be difficult to adhere to on a daily basis, and can be costly. Because of these and other challenges, it is sometimes necessary to temporarily stop treatment. However, these are only recommended in specific situations—and you should never stop therapy without first speaking with your health care provider. Read more in the following lesson: