Table of ContentsView AllTable of ContentsBackgroundAntiretroviral TherapyTreatment GuidelinesStarting TreatmentLifestyleOTC TherapiesComplementary TherapyFrequently Asked QuestionsNext in HIV/AIDS GuideWhat Is HIV/AIDS?
Table of ContentsView All
View All
Table of Contents
Background
Antiretroviral Therapy
Treatment Guidelines
Starting Treatment
Lifestyle
OTC Therapies
Complementary Therapy
Frequently Asked Questions
Next in HIV/AIDS Guide
This article is part ofHealth Divide: HIV, a destination in our Health Divide series.
Thanks to advances in treatment, people withHIVare living longer, healthier lives than ever before. Although there is still no cure for the disease, HIV is today considered a chronic, manageable condition with numerous medications able to control the infection.
2:51Understanding HIV and AIDS
2:51
Understanding HIV and AIDS
Even so, only around 66% of the 1.2 million people living with HIV in the United States are undergoing treatment. Approximately 57% are able to achieveviral suppressionneeded to stop the disease from progressing.
The fixed-dose combination drug Odefsey.Gilead Sciences
Ask an Expert: What Are the Challenges With Getting HIV Care?
HIV infects a type of cell called aCD4 T-cell. This is the cell that helps launch the body’s immune response. Once the HIV enters a CD4 T-cell, it “hijacks” its genetic machinery and turns it into an HIV-producing factory, churning out multiple copies of itself until the cell eventually dies.
As more and more CD4 T-cells are destroyed, theimmune systembecomes less and less able to defend the body against otherwise common infections, referred to asopportunistic infections (OIs). Without treatment, the immune defenses are eventuallycompromised, leaving the body vulnerable to an ever-increasing number of potentially life-threatening OIs.
Prior to the introduction ofcombination antiretroviral therapyin 1996, the average life expectancy for a 20-year-old newly infected with HIV was just 17 years. With today’s medications, a typical 20-year-old is expected to live well into their 70s if diagnosed and treated early.
However, in order to sustain anundetectable viral load, you need totake your medicationevery day. Unfortunately, some individuals are unable to do so. This is especially true for people who don’t have access to adequate or consistent health care. Without viral suppression, you’re more likely to infect others, increasing infection rates in their community.
Infection Rates Among Black PeopleAccording to the Centers for Disease Control and Prevention (CDC), fewer Black people with HIV have sustained viral suppression compared with people of Latin American culture or White people. This accounts in part for why 43% of all new infections are among Black people, despite the fact that Black people only account for 12% of the U.S. population.
Infection Rates Among Black People
According to the Centers for Disease Control and Prevention (CDC), fewer Black people with HIV have sustained viral suppression compared with people of Latin American culture or White people. This accounts in part for why 43% of all new infections are among Black people, despite the fact that Black people only account for 12% of the U.S. population.
Health Disparities in HIV
Verywell / Julie Bang
How Antiretrovirals Work
Antiretrovirals target specific stages of the virus’ life cycle, blocking enzymes or proteins that the virus needs to make copies of itself. Without the means to replicate, the virus can quickly be suppressed to undetectable levels. This not only keeps the immune system intact, reducing the risk of OIs but also prevents others from getting infected.
Studies have confirmed that having and sustaining an undetectable viral load cuts therisk of infecting others to zero.
The following chart includes antiviral medicines recommended to treat HIV in the United States.
How Antiretroviral Therapy Works for HIV
Combination Therapies
Antiretroviral drugs are used in combination. By blocking more than one stage in the virus’ life cycle, the drugs are better able to achieve and sustain viral suppression. HIV drugs used on their own (referred to as monotherapy) cannot do this.
Combination therapy also reduces the risk of HIV drug resistance. With monotherapy, strains of the virus can mutate or begin to vary, which results in the single drug being ineffective against the strain. If the variant strain is drug-resistant, it can continue to multiply and eventually become the predominant strain. This can lead to a condition known as “treatment failure,” in which the drugs no longer work effectively.
Delayed Diagnoses in Black PeoplePeople who delay treatment almost invariably have worse outcomes. Black people with HIV are more likely to present with an AIDS-defining illness due to delay in diagnosis.Misconceptions about HIV drugs, distrust in the public health system, decreased access to healthcare systems, poverty, stigma, and other structural barriers all contribute to these delays.
Delayed Diagnoses in Black People
People who delay treatment almost invariably have worse outcomes. Black people with HIV are more likely to present with an AIDS-defining illness due to delay in diagnosis.Misconceptions about HIV drugs, distrust in the public health system, decreased access to healthcare systems, poverty, stigma, and other structural barriers all contribute to these delays.
Integrase inhibitorsare the ideal drug for most people newly diagnosed with HIV (due to their ease of use, low risk of side effects, and overall durability and effectiveness). In December 2019, the HHS reaffirmed integrase inhibitors as the preferred class of drugs for the first-line treatment of HIV.
All five preferred, first-line therapies include an integrase inhibitor as part of combination therapy.
Prior to starting treatment, a healthcare provider will order tests to understand the variation of the virus. This involves a blood test, called genetic resistance testing, that can identify mutations associated with drug resistance. Based on the number and types of mutations you have, the test can predict which drugs will work most effectively for you.
A healthcare provider will also order baselineCD4 countand viral load tests. The CD4 count measures the number of CD4 T-cells in a sample of blood and is used as a general measurement of your immune strength. The baseline viral load allows your healthcare professional to monitor how well you are responding to treatment based on the number of viruses in your blood.
Changing Treatment
Treatment failure is most often the result of a lack of adherence to medication regimen but can also occur naturally over time as drug-resistant mutations slowly develop. You can also acquire a drug-resistant strain.
If treatment is failing, your healthcare provider will again profile your virus to see which drugs it is sensitive to. In addition to genetic resistance testing, another test—called phenotypic testing—may be ordered. This involves directly exposing the virus to all available antiretrovirals to see which ones work best.
Based on the results of these tests and recommendations from the HHS, your healthcare provider can select the best combination of drugs for you.
Treatment Failiure Among Black People
Are We Close to a Cure for HIV?
Managing HIV is about more than just pills. It is also important to manage any issues in your life that can affect your adherence or increase your risk of OIs. Because you only see your healthcare provider occasionally, it is up to you to manage your health over the long term. The choices you make can directly impact your health.
Adherence
One of the key ways to ensure long-term adherence is to remain linked to HIV-specific care. This means seeing your healthcare provider one to three times yearly to get your blood checked and prescriptions refilled.
If you can’t and find your current drug regimen difficult, speak with your doctor. In some cases, your doctor may be able to switch you to a once-daily, all-in-one tablet.
Viral Suppression Among Black PeopleBlack people with HIV have the lowest rate of viral suppression, with only 51% able to achieve an undetectable virus.Moreover, Blackmen who have sex with men (MSM)are 60% less likely to have an undetectable viral load than White MSM. The combination of poverty and homophobia contributes to this disparity.
Viral Suppression Among Black People
Black people with HIV have the lowest rate of viral suppression, with only 51% able to achieve an undetectable virus.Moreover, Blackmen who have sex with men (MSM)are 60% less likely to have an undetectable viral load than White MSM. The combination of poverty and homophobia contributes to this disparity.
The High Risk of Gay Black Men Getting HIV
General Health
HIV cannot be managed in isolation. It requires a holistic approach to avoid HIV-associated illnesses as well as non-HIV-associated illnesses that are the most common causes of death in people living with HIV today.
In the United States, people with HIV are more likely to die from heart disease, cancer, and liver disease than from HIV itself. Because HIV places the body under persistent inflammation, these diseases often occur 10 to 15 years earlier than in the general population.
If you have HIV, you need to adhere to the same general health recommendations as everyone else. This includes:
Accessing Healthcare Among Black MalesAround 77% of Black people newly diagnosed with HIV are linked to health care. Of these, only 3 of every 5 Black heterosexual males between the ages of 13 and 24 or 45 and 54 receive care.HIV stigma and conspiracy theories keep many of these men from seeking treatment.
Accessing Healthcare Among Black Males
Around 77% of Black people newly diagnosed with HIV are linked to health care. Of these, only 3 of every 5 Black heterosexual males between the ages of 13 and 24 or 45 and 54 receive care.HIV stigma and conspiracy theories keep many of these men from seeking treatment.
The Link Between HIV and Mental Health
Over-the-Counter (OTC) Therapies
Over-the-counter (OTC) medications have no effect on HIV infection. Even though some manufacturers will market their products as “immune boosters,” they ultimately do nothing to treat the infection or alter the course of the disease.
With that said, there are OTC medications that are sometimes used to relieve symptoms of the disease or side effects of treatment. These include:
6 Prescription Drugs to Avoid If Taking HIV Therapy
Complementary and Alternative Medicine (CAM)
There are nocomplementary or alternative therapiesthat can take the place of antiretroviral therapy. With that said, sometimes people with HIV will turn to alternative medicine to better manage symptoms or relieve side effects.
To avoid interactions and other possible harms, speak with your healthcare provider before adding any complementary or alternative therapy to your treatment plan.
Medical Marijuana
Medical marijuanahas long been used to treat pain, reduce nausea, and stimulate appetite in people with HIV. Even so, evidence is lacking as to whethercannabisin any form offers real benefits. A few studies have suggested that THC (the psychoactive ingredient of marijuana) may provide short-term relief of peripheral neuropathy when smoked.
Yoga and Meditation
HIV is associated with high rates of stress, anxiety, and depression, particularly in communities where HIV is stigmatized. These emotions can affect your ability to adhere to treatment.Yoga, meditation, and other mind-body therapies cannot overcome these issues on their own but may help manage stress and anxiety as part of an overall treatment plan.
Coping and Living Well With HIV
A Word From Verywell
HIV testingcan be conducted confidentially. If youtest positiveand need treatment, there are manyfederal, state, and institutional programsthat can help pay for your treatment and care.
The primary goal is to reduce the viral population to undetectable levels. This prevents disease progression and dramatically reduces the risk of opportunistic infections and death.
When you stop antiretroviral therapy, the viral number will rebound. In the end, antiretrovirals don’t kill HIV; they simply suppress the virus and keep it from destroying your immune system. If you stop and start treatment, the virus also has a greater chance of developing drug-resistant mutations, making your drugs less effective.
Until recently, that was the case. But in 2021, the FDA approved a combination therapy called Cabenuva, which can be given monthly or every two months.The combination of two different injectable antiretrovirals, cabotegravir and rilpivirine, has proven to be just as effective in suppressing HIV as once-daily oral options.
For severelyimmunocompromisedpeople, prophylactic (preventive) drugs may be prescribed to avoid opportunistic infections liketoxoplasmosis,tuberculosis,pneumocystis pneumonia, and others. Vaccination forhepatitis A,hepatitis B,human papillomavirus (HPV),influenza,pneumococcal disease, andshinglesare recommended for everyone with HIV.
No. Antiretrovirals are the only treatments that can block viral replication and prevent disease progression. There are no “immune boosters,” supplements, or endorsed medical procedures that can“cure” HIVor alter the course of the disease in any way.
List of Approved HIV Antiretroviral Drugs
27 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Department of Health and Human Services.What is the HIV care continuum?.
Marcus JL, Chao CR, Leyden WA, et al.Narrowing the gap in life expectancy between HIV-infected and HIV-uninfected individuals with access to care.J Acquired Immune Def Syn. 2016;73(1):39-46. doi:10.1097/QAI.0000000000001014
Crepaz N, Dong X, Wang X, Hernandez AL, Hall HI.Racial and ethnic disparities in sustained viral suppression and transmission risk potential among persons receiving HIV care—United States, 2014.MMWR Morb Mortal Wkly Rep. 2018;67(4):113–118. doi:10.15585/mmwr.mm6704a2
Rodger A, Cambiano V, Bruun T, et al.Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study.Lancet.2019;393(10189):2428-2438. doi:10.1016/S0140-6736(19)30418-0
National Institutes of Health: HIVinfo.FDA-approved HIV medicines.
Cuevas JM, Geller R, Garijo R, López-Aldeguer J, Sanjuán R.Extremely high mutation rate of HIV-1 in vivo.PLoS Biol. 2015;13(9):e1002251. doi:10.1371/journal.pbio.1002251
HHS Panel on Antiretroviral Guidelines for Adults and Adolescents.Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV. What’s new in the guidelines.
Lyons SJ, Dailey AF, Yu C, Johnson AS.Care outcomes among Black or African American persons with diagnosed HIV in rural, urban, and metropolitan statistical areas—42 U.S. jurisdictions, 2018.MMWR Morb Mortal Wkly Rep. 2021;70(7):229–235. doi:10.15585/mmwr.mm7007a1
HHS Panel on Antiretroviral Guidelines for Adults and Adolescents.Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV. Laboratory testing for initial assessment and monitoring of patients with HIV receiving antiretroviral therapy.
HHS Panel on Antiretroviral Guidelines for Adults and Adolescents.Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV. Management of people with HIV and antiretroviral therapy experience: virologic failure.
Ribaudo HK, Smith HY, Robbins GK, et al.Racial differences in response to antiretroviral therapy for HIV infection: an AIDS Clinical Trials Group (ACTG) Study analysis.Clin Infect Dis.2013;57(11):1607–1617. doi:10.1093/cid/cit595
Sullivan PS, Knox J, Jones J, et al.Understanding disparities in viral suppression among Black MSM living with HIV in Atlanta Georgia.J Int AIDS Soc.2021;24(4):e25689. doi:10.1002/jia2.25689
Croxford S, Kitching A, Desai S, et al.Mortality and causes of death in people diagnosed with HIV in the era of highly active antiretroviral therapy compared with the general population: an analysis of a national observational cohort.Lancet Pub Health.2017;2(1):e35-e46. doi:10.1016/S2468-2667(16)30020-2
Heller J.Rumors and realities: making sense of HIV/AIDS conspiracy narratives and contemporary legends.Am J Public Health.2015;105(1):e43–e50. doi:10.2105/AJPH.2014.302284
Brown S, Simpson DM, Moyle G, et al.NGX-4010, a capsaicin 8% patch, for the treatment of painful HIV-associated distal sensory polyneuropathy: integrated analysis of two phase III, randomized, controlled trials.AIDS Res Ther.2013;10(1):5. doi:10.1186/1742-6405-10-5
Sauka M, Selga G, Silova A, Westermarck T, Latvus A, Atrosha F.Impact of CoQ10, L-carnitine and cocktail antioxidants on oxidative stress markers in HIV patients — mini review and clinical trial. IntechOpen;2014.
Hileman CO, Overton ET, McComsey GA.Vitamin D and bone loss in HIV.Curr Opin HIV AIDS. 2016;11(3):277–84. doi:10.1097/COH.0000000000000272
Ware MA, Wang T, Shapiro S, et al.Smoked cannabis for chronic neuropathic pain: a randomized controlled trial.CMAJ. 2010;182(14):e694-e701. doi:10.1503/cmaj.091414
Rintamaki L, Kosenko K, Hogan T, et al.The role of stigma management in HIV treatment adherence.Int J Environ Res Public Health. 2019;16(24):5003. doi:10.3390/ijerph16245003
Naoroibam R, Metri KG, Bhargav H, Nagaratna R, Nagendra HR.Effect of integrated yoga (IY) on psychological states and CD4 counts of HIV-1 infected patients: A randomized controlled pilot study.Int J Yoga.2016;9(1):57-61. doi:10.4103/0973-6131.171723
Hussain N, Said ASA.Mindfulness-based meditation versus progressive relaxation meditation: impact on chronic pain in older female patients with diabetic neuropathy.J Evid Based Integr Med.2019;24:2515690X19876599. doi:10.1177/2515690X19876599
Lundgren JD, Babiker AG, Gordin F, et al.Initiation of antiretroviral therapy in early asymptomatic HIV infection.N Engl J Med. 2015;373(9):795-807. doi:10.1056/NEJMoa1506816
Szubert AJ, Prendergast AJ, Spyer MJ, et al.Virological response and resistance among HIV-infected children receiving long-term antiretroviral therapy without virological monitoring in Uganda and Zimbabwe: observational analyses within the randomised ARROW trial.PLoS Med. 2017;14(11):e1002432. doi:10.1371/journal.pmed.1002432
Food and Drug Administration.Cabenuva label.
Food and Drug Administration.FDA approves first extended-release, injectable drug regimen for adults living with HIV.
HHS Panel on Antiretroviral Guidelines for Adults and Adolescents.Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV. Table 1. Chemoprophylaxis to prevent first episode of opportunistic disease.
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Facts About HIV/AIDS You May Not KnowHIV: Signs and Symptoms to Look Out ForCause and Risk Factors of HIVWhat to Expect Before, During, and After an HIV TestAn Overview of HIV Treatment
Facts About HIV/AIDS You May Not Know
HIV: Signs and Symptoms to Look Out For
Cause and Risk Factors of HIV
What to Expect Before, During, and After an HIV Test
An Overview of HIV Treatment
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