Starting HIV Treatment
Learn what to expect when starting HIV treatment and how to work with your healthcare provider.
Learn what to expect when starting HIV treatment and how to work with your healthcare provider.
The NIH HIV treatment guidelines recommend that all people with HIV start antiretroviral therapy (ART) as soon as possible after diagnosis, regardless of CD4 count or viral load. Starting treatment early:
Your provider will order baseline tests including HIV viral load, CD4 count, complete blood count, kidney and liver function tests, and drug resistance testing to guide medication selection.
Some people experience mild side effects when starting ART, such as nausea, fatigue, or headache. These often improve within a few weeks. Contact your provider if side effects are severe or persistent.
Your provider will check your viral load about 4 weeks after starting ART to see if the medication is working. The goal is to reduce viral load to undetectable levels.
Most people achieve an undetectable viral load within 3–6 months of starting ART. Once undetectable, you cannot transmit HIV through sex (U=U).
After achieving viral suppression, you'll typically have lab tests every 3–6 months and clinic visits every 6–12 months, depending on your health status.
Your healthcare provider will recommend an ART regimen based on your individual circumstances, including your viral load, CD4 count, drug resistance test results, other health conditions, and lifestyle factors. Modern HIV regimens are often a single pill taken once a day. The NIH AIDSinfo guidelines provide detailed recommendations for initial ART regimens.
Preferred initial regimens for most adults include combinations such as bictegravir/tenofovir alafenamide/emtricitabine (Biktarvy®) and dolutegravir/abacavir/lamivudine (Triumeq®), among others. Your provider will help you choose the best option.
Adherence — taking your HIV medication every day as prescribed — is the most important factor in treatment success. Missing doses can allow HIV to replicate and potentially develop resistance to medications. Tips for staying adherent: