How Does Antiretroviral Treatment Work
Without treatment HIV attacks the immune system – the part of your body that protects you from other infections. If people living with HIV dont take treatment they become more vulnerable to other illnesses.
ART stops HIV from making copies of itself. This keeps the amount of virus in your body low, protecting your immune system so youre less likely to get sick.
With good healthcare and treatment, people with HIV can expect to live as long as people who dont have HIV. You can continue to have relationships, to work or study, to make plans, to have a family whatever you would have done before your HIV diagnosis.
By keeping the amount of HIV in your body low, ART also reduces the risk of HIV being passed on. People living with HIV who take their treatment properly can achieve something called an undetectable viral load. This is when the amount of HIV in their body has been reduced to such low levels that it cant be passed on through sex. To know if you have an undetectable viral load, its important to attend regular appointments with your healthcare team to have your viral load measured this can tell you how effective your treatment is and how much HIV there is in your body.
Medical Care And Case Management
- Expert management of HIV Infection and complications related to AIDS
- Primary medical care
- Coordination with your physician and medical case management
- Specialty referrals
- Mental health counseling
- Harm reduction/Safer sex education
- Risk-reduction counseling and education: Includes assistance with substance use, disclosure, interpersonal concerns, and other risk behaviors
- Tobacco cessation counseling
- Nutritional assessments, counseling, and assistance
- Support group for gay and bisexual men living with HIV
Why Is Hiv Treatment Important
Getting and staying on HIV treatment because it reduces the amount of HIV in your blood to a very low level. This keeps you healthy and prevents illness. There is also a major prevention benefit. People living with HIV who take HIV medication daily as prescribed and get and keep an undetectable viral load have effectively no risk of sexually transmitting HIV to their HIV-negative partners. This is called treatment as prevention.
If left untreated, HIV attacks your immune system and can allow different types of life-threatening infections and cancers to develop. If your CD4 cell count falls below a certain level, you are at risk of getting an opportunistic infection. These are infections that dont normally affect people with healthy immune systems but that can infect people with immune systems weakened by HIV infection. Your health care provider may prescribe medicines to prevent certain infections.
HIV treatment is most likely to be successful when you know what to expect and are committed to taking your medicines exactly as prescribed. Working with your health care provider to develop a treatment plan will help you learn more about HIV and manage it effectively.
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How Do I Protect Myself From Hiv
There are a number of ways you can protect yourself from HIV, including:
- using a condom every time you have vaginal, anal or oral sex
- in some countries PrEP is available. This is a course of HIV drugs which if taken consistently as advised by your healthcare professional prevents HIV infection through sex
- avoiding sharing needles, syringes and other injecting equipment
- taking HIV treatment if you are a new or expectant mother living with HIV, as this will dramatically reduce the risk of passing HIV to your baby during pregnancy, childbirth and breastfeeding
- asking your healthcare professional if the blood product you are receiving has been tested for HIV
- taking precautions if you are a healthcare worker, such as wearing protection , washing hands after contact with blood and other bodily fluids, and safely disposing of sharp equipment
- if you think you have been exposed to HIV you may be able to access PEP, a 4-week course of ARV drugs taken after possible HIV exposure to prevent HIV infection. You must start PEP within 72 hours of possible exposure to be effective.
For more detailed information on how to prevent HIV infection visit the relevant page from the listed below:
Where Can You Get Tested For Hiv
You can get an HIV test at many places:
- Your health care providers office
- Health clinics or community health centers
- STD or sexual health clinics
- Your local health department
- Substance abuse prevention or treatment programs
Many pharmacies and some community-based organizations also offer HIV testing.
HIV testing is covered by health insurance without a co-pay, as required by the Affordable Care Act. If you do not have health insurance, some testing sites may offer free tests.
These places can connect you to HIV care and treatment if you test positive or can discuss the best HIV prevention options for you if you test negative.
You can also buy a home testing kit at a pharmacy or online.
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How Does A Person Get Hiv
HIV can only be passed by these five body fluids:
- blood
- vaginal fluid
- breast milk
HIV can be passed when one of these fluids from a person with HIV gets into the bloodstream of another personthrough broken skin, the opening of the penis or the wet linings of the body, such as the vagina, rectum or foreskin. HIV cannot be passed through healthy, unbroken skin.
The two main ways that HIV can be passed are:
- through sex
- by sharing needles or other equipment to inject drugs
HIV can also be passed:
- to a fetus or baby during pregnancy, birth or breastfeeding
HIV cannot be passed by:
- shaking hands, working or eating with someone who has HIV
- hugs or kisses
- swimming pools, toilet seats or water fountains
- insects or animals
Since November 1985, all blood products in Canada are checked for HIV, to ensure that it is safe to get a blood transfusion. And there is no chance of getting HIV from donating blood.
What You Can Do To Reduce Stigma
You can help reduce stigma by being respectful, compassionate and non-judgemental. Model this behaviour for others when you witness stigmatizing behaviours.
When talking about HIV, certain terms can be stigmatizing. Be thoughtful about the words you use when discussing the topic.
Learn more about the facts of HIV. Treatment can lower the amount of virus in a person’s blood to a level that’s too low to be measured on a standard blood test. This means it’s undetectable.
People living with HIV on treatment who maintain an undetectable viral load have effectively no risk of transmitting HIV to their sexual partners.
Knowing and sharing these facts widely can help to reduce stigma. Share our Undetectable = Untransmittable infographic to help us raise awareness.
In addition, HIV is not transmitted through:
- healthy, unbroken skin
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Whats The Treatment For Hiv
Theres no cure for HIV, but there are treatments that help people with HIV live long, healthy lives. Antiretroviral therapy is a combination of medicines that slows down the effects of HIV in your body and can help you stay healthy for many years. It can also lower or even stop your chances of giving HIV to anyone else.
ART lowers the amount of HIV in your body sometimes to the point where HIV wont show up on standard blood tests. If your HIV viral load is so low that certain tests cant see it, its called undetectable. When someone has an undetectable viral load, they cant spread HIV to others during sex.
Its important to remember that even with an undetectable viral load, HIV is still present in your body. If you stop treatment your viral load can go up, making it possible to pass HIV to others you have sex with. Your doctor or nurse can help you find the treatment thats best for you to help keep your viral load low, so you can stay healthy.
Paying attention to your lifestyle can help you stay healthy too. This means eating well, getting enough sleep, exercising, learning how to deal with stress, and avoiding alcohol, smoking, and drugs.
The Challenge Of Curing Hiv
Because of the nature of HIV, discovering a cure comes with some specific challenges. The most significant of these challenges is the viruss ability to hide itself and lay dormant in pockets of host cells that are unrecognised as harbouring HIV by the immune system. Even if an individual has successfully suppressed their HIV through ARV treatment, the hidden HIV, called the latent reservoir, can re-emerge if ARV treatment is stopped.
Because of this underlying barrier, examples of HIV cure have been few and far between throughout the entire history of the HIV epidemic. In fact, there have been only two instances of confirmed HIV cure, in which HIV cannot be found in in blood or biopsies of two PLHIV , and these patients went on to successfully stop daily ARV treatment and did not experience a rebound in their HIV. 1
These individuals were cured of their HIV after treatment for their separate cancer diagnosis, which required a series of difficult and intensive treatments. While their treatments were extremely high risk and not amenable to wide scale implementation, these instances of cure bring hope of what is possible in our efforts to end the HIV epidemic.
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Other Specialized Hiv Care
Casey House
Casey House is a hospital providing both compassionate in-patient health care and community programming for people with HIV/AIDS.
Casey House provides:
- Day health care
- Community care and outreach
- help with finding supportive housing for people with HIV/AIDS
- programs that provide volunteer in-home hospice care
What Is Involved In The Consistent And Correct Use Of Hiv Treatment To Maintain An Undetectable Viral Load For Hiv Prevention
The consistent and correct use of HIV treatment to maintain an undetectable viral load includes:
- high adherence to medications, to achieve and maintain an undetectable viral load
- regular medical appointments to monitor viral load and receive adherence support, if needed
Regular testing and treatment for sexually transmitted infections is also important because HIV treatment does not protect against STIs.
A person on HIV treatment needs to work with their doctor to determine an appropriate schedule for medical checkups and viral load monitoring.
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How Is Hiv Treated
HIV is treated with HIV medications . These medications have to be taken as prescribed by your doctor. They cannot get rid of HIV but they can keep it under control.
If you are diagnosed with HIV, the sooner you start treatment, the better it is for your health.
Taking HIV treatment exactly as prescribed and maintaining a suppressed viral load also prevents HIV transmission.
Without HIV treatment, your immune system can become too weak to fight off serious illnesses, and you can eventually become sick with life-threatening infections and cancers. This is called AIDS . But thanks to effective HIV treatment, these days most people with HIV never get AIDS.
How Can You Get Hiv
HIV is found in the following bodily fluids of someone living with the virus:
- blood
- vaginal fluids
- breastmilk.
For you to get HIV, these bodily fluids need to get into your blood through a mucous membrane , via shared injecting equipment, or through broken skin .
There is not enough HIV virus in other bodily fluids, like saliva, sweat or urine, to transmit it from one person to another.
Someone living with HIV who has an undetectable viral load, meaning effective treatment has lowered the amount of virus in their blood to levels where it cannot be detected by a normal blood test, cannot pass on HIV.
A person living with HIV with a detectable viral load can pass the virus to others whether they have symptoms or not.
HIV is most infectious in the first few weeks after infection. At this time many people are unaware of their status.
The main ways you can get HIV are:
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Understanding Hiv And Aids
Survival with HIV requires that you maintain regular and consistent treatment. Only around 65% of the 1.2 million Americans who have HIV are on treatment, according to the U.S. Department of Health and Human Services. Of these, an estimated one in four will drop out of HIV-specific care, and only 56% will achieve the complete viral suppression that is needed to avoid disease progression.
Find Needle Exchange And Harm Reduction Programs
You can get free sterile harm-reduction supplies at over 35 needle exchange programs and over 370 access points across Ontario. Through these programs you can get:
- safer-injection equipment including:
Through these programs, you can also:
- safely dispose of both injection and crack smoking equipment
- get condoms
- get education and information
- get referrals and counseling
Find the closest needle-exchange and harm-reduction program by contacting a public health unit near you or call the AIDS and Sexual Health Info Line toll free at 1-800-668-2437.
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Aids Drug Assistance Program
The Ryan White HIV/AIDS Program includes the AIDS Drug Assistance Program , which is funded by the federal government to help pay for HIV drugs for people who might not be able to afford them otherwise. This fund may even be used to pay for health insurance premiums for eligible clients in some cases.
Each US state provides its own coverage, and your local ADAP office can let you know which drugs it pays for and what the income limits are for your state. If you become part of the ADAP program, you will need to recertify every six months. Your local ADAP office can support you in this process as well.
In the past, some states have had a waiting list for ADAP. In other states, the ADAP program is big enough to cover not only HIV drugs, but also laboratory work, some medical care, and non-HIV medications, like those used to manage side effects and other chronic diseases.
The Ryan White program can also pay for doctor visits and support services for people living with HIV. In some instances, family members who are not living with HIV can receive support through a Ryan White program for women and/or children living with HIV. To find out more about the Ryan White program in your state, call your state’s HIV/AIDS hotline.
What If I Have Another Illness Or A Co
You may have a co-infection or another illness such as cardiovascular disease, HIV-related cancer, chronic kidney disease or HIV-associated neurocognitive impairment.
In these situations your doctor may need to tailor your antiretroviral treatment or treat your other condition before starting your HIV treatment. This will be explained to you by the clinicians looking after you.
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Does Antiretroviral Treatment Have Side
As with all medication, starting to take ARVs can cause some side-effects, particularly in the first few days of treatment. This is another topic you could discuss with your doctor, as it might also affect your choice of drugs. Your treatment will be monitored and you may be recommended to switch drugs if they aren’t working for you or if you’re finding the side effects difficult to manage.
Pharmacologic Enhancers Or Drug Boosters
Ritonavir , taken in a low dose, increases blood levels of lopinavir and the drug LPV/r .
- Zidovudine + Lamivudine or ZDV/3TC
Descovy and Truvada have also been approved as ways to prevent HIV infection for people who are at high risk. But if you take either of them, you have to practice safe sex, too.
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Hiv Treatment Is Free And Better Accessible
The good news for people living with HIV in NSW is that changes made in October 2015, meant that patients of NSW public hospitals or authorised community prescribers in NSW were no longer required to pay the patient co-payments for Section 100 Highly Specialised Drugs. This essentially made access to HIV treatment free.
The changes applied regardless of whether prescriptions are filled through NSW public hospitals, NSW community pharmacies or pharmacies used by NSW public hospital oncology services.
You can also get your meds in more ways than ever. Treatment can be dispensed from public hospitals, GPs, hospital-attached and community-based pharmacies, and local chemists some of which providing home delivery services. Learn more here.
Who Should Get Tested
Anyone can become infected with HIV regardless of:
- Age
- Sexual orientation or
- Race or ethic origin.
Knowing if you have HIV means you can seek treatment and protect your partner or partners. If HIV is present in your body, you can pass it on to other people even if you feel perfectly healthy.
If you get tested and you do not have HIV, you can protect yourself from future infection.
It is important that you get tested for HIV early, before you become sick. Many people who are diagnosed early and take their medication can live healthy lives.
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How Well Does The Use Of Hiv Treatment To Maintain An Undetectable Viral Load Prevent Hiv Transmission To A Baby During Pregnancy And Birth
Without treatment, there is a 15% to 30% chance that a baby born to a person living with HIV will get HIV during pregnancy or delivery. Taking HIV treatment is the most effective way to reduce transmission to the baby. In fact, research has shown that if a pregnant person starts HIV treatment before conception and maintains an undetectable viral load throughout pregnancy and delivery, they do not transmit HIV to their baby. A short course of HIV medications is also given to the infant to prevent HIV transmission.
For the last three decades, a growing body of evidence has shown that babies are much less likely to be born with HIV if the pregnant parent is on treatment. A study of the French Perinatal Cohort, conducted between 2000 and 2011, is the largest study to show the impact of treatment on preventing HIV transmission to a newborn. This study found that no HIV transmissions occurred among 2,651 infants born to cisgender women who were on treatment before they conceived and throughout their pregnancy, who had an undetectable viral load at delivery and who did not breastfeed.