Even if you’re “feeling fine,” follow your HIV treatment as prescribed.
Today, people with HIV (human immunodeficiency virus) can live long and relatively normal lives. That’s thanks to the wide range of incredible and life-saving medications known as antiretroviral therapy (ART). However, those medications only work if you stick to your HIV treatment exactly as your doctor prescribed.
Sticking to your HIV treatment is known as adherence. People may not adhere to their prescriptions for a number of reasons. For example, you may have trouble remembering to take your pills, affording your treatment, or dealing with side effects. Either way, the results can be dangerous for your health.
How HIV Treatment Works
HIV treatment works by preventing the virus from replicating. This helps keep your viral load low, which is the amount of virus in your bloodstream. Thanks to treatment, many people with HIV have viral loads that are low enough that the risk of transmitting the virus to others is low. Plus, they can expect to have a similar lifespan as someone without HIV.
Why It’s Essential to Stick to Antiretroviral Therapy
But here’s the catch: You have to take your medication as prescribed. That means taking it daily, and not missing or skipping doses. It also means taking it with or without food (as told by your doctor), and avoiding taking medicines that you know may interfere with your antiretrovirals.
What makes this challenging is that you can’t always “feel” your medication working. For example, people might be motivated to take medication for arthritis because it noticeably relieves their joint pain. On the other hand, HIV doesn’t cause obvious symptoms. As a result, it can be hard to remember or prioritize taking your HIV treatment, especially on days where you feel totally fine.
The problem is, not taking your HIV treatment as prescribed can allow HIV to replicate. As a result, the high viral load will lead to a reduced CD4 count. This refers to the number of CD4 T cells, which is a type of immune cell that HIV attacks. As your viral load increases and your CD4 count decreases, your immune system will continue to weaken.
A weakened immune system means you’ll be very vulnerable to infections and other illnesses. When you do have infections, you’ll have a harder time fighting them off. This means that fairly common infections (like pneumonia) can become life threatening.
Slowing the Progression
Today, many people live with HIV without ever progressing to AIDS (acquired immunodeficiency syndrome). HIV progresses to AIDS when an individual’s CD4 count drops below 200. For context, normal CD4 levels are usually above 500.
Sticking to your HIV treatment as prescribed can help prevent that from happening. People who keep their CD4 counts at normal levels are better able to prevent and fight illnesses and live a long and healthy life.
The takeaway: Taking your prescribed treatments is an investment in your future. It can help you have the family you’ve dreamed of, take the trips you’ve had on your bucket list, and reach the career goals you’ve set for yourself. If you have any issue sticking with your HIV medication, talk to your doctor. They can help you find the routines that work, or the medication that’s a better fit for you.
Stella A. Safo, MD, is an HIV primary care physician and assistant professor of Medicine at the Icahn School of Medicine at Mount Sinai Hospital.