When To Start

Considering when to start

HIV treatments are made up of combinations of HIV antiretroviral drugs. These treatments are very effective at stopping the virus from reproducing, which allows the immune system to fight infections.

Treatment is now recommended for all people with HIV, regardless of disease stage, so the question of ‘when to start’ will depend on your readiness. It may include both a desire to maximise your health and a wish to reduce your infectiousness.

There are a number of issues to be considered when deciding when to start treatment. HIV treatments:

  • reduce the amount of HIV in your body. If you are feeling unwell, that will make you feel better and/or it will take longer for you to become sick. Treatment is now recommended for all HIV-infected people, irrespective of CD4 count, to reduce the risk of disease progression.
  • can reduce the amount of HIV in your body to an undetectable level. That makes it unlikely you will pass HIV on to someone else if you have maintained an undetectable viral load for six months or more, take your medication as prescribed, do not have any STIs, and have regular check-ups. Ask your doctor for advice.
  • may cause side-effects but these are often manageable and short term as they occur while your body gets used to the medication. Some people experience no side-effects at all. More serious or long-term side-effects are less common than they used to be but if you notice any symptoms it is important to talk to your doctor about how to address them as soon as possible. Many persistent side-effects can be reduced by medication. You must not stop treatment without talking to your doctor as doing so can have long-term harmful consequences.
  • can be difficult to manage because you need to take your treatment exactly as your doctor tells you – at the same time each day. This is known as treatment adherence. Treatment adherence is vital or the drugs will become less effective, even if you start taking them regularly again. Drug schedules used to be complex but they are now much simpler with some people taking only a single pill each day. Still, you may need to think through issues like how to store your drugs, how to fit them in around meals, and travelling. Your doctor or health worker should have some suggestions about how to manage this. You can also check out AFAO’s HIV Treatment Adherence factsheet or NAPWHA’s Adherence Tips.
  • are a long term commitment. Once you start treatment, you should keep taking it. You should not stop because HIV can become ‘resistant’ to treatment – meaning the HIV treatments won’t work properly if you need to start taking them again. Stopping suddenly can also trigger significant deterioration in your health.

“There is no all-knowing person out there who knows what’s best for you. I’m on treatment. I exercise. I travel. It’s worth putting your energy into things that make you feel good about yourself. Do what’s best for you.”

“The treatment side-effects aren’t too bad for me. I have just got used to taking them now – it’s like second nature. I don’t like the fact that I need them, but the reality is that they’re no big deal.”