Roadmap to HIV Therapies

When to Start HIV Therapy?

Deciding when to start a therapeutic regimen is an important decision, and there are no "right" answers, only answers that are right for you.

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Starting any therapy can cause anxiety. There is no one proven "right" time to start anti-HIV therapy, for example, for everyone. There are differing opinions about starting therapy early in the course of HIV infection vs. later. Either choice has possible long-term consequences.

Most important, it doesn't make sense to start therapy until you are ready and committed to it.  Making a decision about what criteria you will use as a basis for starting therapy (of any kind, anti-HIV therapy, herbal therapy, etc.) puts the decision and control over using therapy in your hands.

Making decisions about complementary therapies are often more difficult and complex because there's a lack of information from studies to help guide decision-making.

Based upon a review of currently available data, Project Inform believes that all HIV-positive people who are ready to begin treatment should start if their CD4 counts fall below 500. Some evidence shows that starting treatment above 500 CD4s — or during acute infection to lower the chance of a low nadir CD4 — may decrease damage to the immune system, promote better longer-term health outcomes, and extend a person’s life.

Deciding on your own criteria, with the guidance of your doctor, lets you be in control of your treatment decisions.

How to monitor whether therapy is working for you?

Before you start any kind of therapy, it's important to have realistic expectations around what the therapy will do and to determine how you will determine if it is working. In terms of anti-HIV therapy, typically you will look for decreases in viral levels (HIV RNA), increases in measure of immune health (CD4+ cell counts) and improvements in your overall general health.

Determining whether a complementary therapy is working, when it doesn't have any direct anti-HIV activity, can be difficult. How will you decide if it's worth your money? (Remember, just because something is available over-the-counter doesn't mean that there are no risks associated with using it!)
 
Talk to your doctor and work together to develop realistic ways of determining if the therapy you want to start is working. If after some agreed upon period of time you are not achieving your goals, agree to revisit the use of the therapy approach you are trying. Have these discussions before you start taking the therapy.


Adapted from: www.projectinform.org