Information for employees of the UN system and their families
Treatment
What treatments exist for HIV/AIDS?
Several different types of drugs exist to treat
HIV infection. These drugs attack various aspects
of the process used by the virus to replicate
itself. Because HIV quickly mutates to become
resistant to any single drug, patients must take
a combination of drugs to achieve maximum
suppression of HIV. Combination anti-HIV therapy is known as antiretroviral therapy, or ART. ART changes the natural course of HIV infection, significantly extending the period between initial infection and the development of symptoms. To achieve these results, it is important to initiate therapy before AIDS symptoms develop, although even patients who start on therapy after being diagnosed with AIDS often receive major and long-lasting health benefits. Although effective in slowing the progression of HIV-related disease, ART is not a cure. 
If I test HIV-positive, does this mean that I’m going to get sick soon?
As a result of medical advances, those of us who
are infected with HIV are now able to live with
the disease, healthily and productively. In
addition, an extraordinary amount of research is
under way to identify even better treatments to
build on those that already exist. HIV infection
is a major medical condition that must be taken
seriously, but it is not necessarily a death
sentence.
If I'm HIV-positive and my physician prescribes
medication for my condition, can I begin anti-HIV
treatment slowly-say, by taking only one pill at
a time?
Because HIV is constantly mutating, it quickly
becomes resistant to any single drug. When
resistance develops, the drugs are not as
effective and the virus begins to rebound. To
prevent or slow down the development of such
resistance, your doctor will prescribe at least
three different anti-HIV drugs. By attacking HIV
from different angles, combination therapy
achieves maximum impact and reduces the
likelihood that drug resistance will develop.
Isn’t taking three drugs at once complicated?
Combination HIV therapy is not simple. Those of
us who are HIV-positive and on therapy will need
to take multiple drugs at least twice a day.
Depending on our regimen, we may have certain
eating restrictions (such as the need to take
drugs with food) and may have to refrigerate one
or more of our drugs.For those of us who are HIV-positive, it is essential that we take our drugs exactly as our physician prescribes them. If we miss doses, fail to take them on time, or otherwise vary our treatment regimen, the drugs will not be as effective as they should be and resistance will develop more quickly.
If I’m HIV-positive, how can I make sure that I’m able to take my medication as prescribed?
Taking medication as prescribed is often referred
to as 'treatment adherence'. Studies show that
most people do not adhere well to therapy,
regardless of their medical condition, level of
education, or annual income. Because treatment
adherence is so critically important in the case
of HIV/AIDS, extra care must be taken to make
sure that HIV drugs are taken exactly as
prescribed.Once those of us who are HIV-positive are prescribed a combination medication regimen, it is a good idea for us to make a personal treatment-adherence plan. The nature of this plan will depend on our own individual treatment regimen and on the dynamics of our individual lives. For some people, creating a daily calendar is a useful way to work treatment into their daily routines. For others, it is helpful to use a daily or weekly planner to keep up with the treatment schedule. Some people use a beeper or alarm clock to remind them when it is time to take a dose, while others rely on friends, family members, or roommates to help them remember. Before you leave your doctor's office with your new treatment regimen, it is a good idea to discuss your treatment-adherence plan with a doctor, nurse or counsellor. Developing a treatment-adherence plan requires that we honestly look at our lives and identify things that might interfere with our ability to take our drugs on time. If we tend to become absent-minded after drinking a little too much alcohol in the evening, for example, it might be wise to avoid situations in which we are likely to drink to excess. If we find it difficult to keep to a schedule because our lives are sometimes chaotic, it might be useful to try to stick to a more standard routine, such as having meals at particular times so that we are more likely to remember to take our drugs. If we forget to take a dose, we should take it as soon afterwards as we remember, unless it coincides with the next dose, in which case we should only take the one dose. Above all, it is important for those of us who are HIV-positive to remember that we are not the only ones facing these challenges. A lot of other people with HIV are in the same situation. Getting together with them to share our experiences and learn from theirs (with respect to adherence and a lot of other issues) can be an extremely healthy way to cope with HIV infection and to learn new strategies for protecting our health.
I understand that having HIV can make you susceptible to other infections. If I’m HIV-positive, how will I protect myself from those?
For those of us who are HIV-positive, we are most
prone to infections once the virus has seriously
damaged our immune system. For most individuals,
combination HIV therapy significantly strengthens
the immune system and reduces susceptibility to
opportunistic infections. If you are
HIV-positive, you should regularly see a doctor
qualified to treat AIDS so that your immune
system can be monitored on an ongoing basis.
Routine monitoring of your immune system will
enable your doctor to prescribe treatments to
prevent some of the opportunistic infections that
can strike people living with HIV.The susceptibility of people with HIV to opportunistic infections underscores the importance of knowing one's HIV status. Many people with HIV who delay testing only learn they are positive when they experience a serious, sometimes life-threatening, illness. By knowing our HIV status, we can take better care of our health and ensure that we are monitored periodically; if we are HIV-positive, our doctors can prescribe medication that can prevent opportunistic infections from developing. 
Treating TB
One potential opportunistic illness that requires
particular attention is tuberculosis (TB). TB is
the leading cause of death among people living
with HIV and is common in many parts of the
world. Most people who have been infected with TB
never develop the active disease because their
immune systems fight off the infection. However,
HIV infection significantly increases the odds
that latent TB infection will turn into active
TB. All of us who are HIV-positive should be
screened to see if we have been exposed to TB,
for which there are preventive therapies.
More Information
To find out more information about the HIV life cycle and treatment options, visit
the following sites (pages will open in a new browser window):
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