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Frequently asked questions about ARVs

Can ARV’s cure HIV?

  • No, ARV’s can decrease the viral load (the amount of virus in the bloodstream), but they are not a cure.
  • Even if the viral load on a blood test is so low that it’s “undetectable”, the virus is not gone.

How can a doctor tell if the ARV’s are working?

  • The viral load should go down and the CD4 count should go up.

What happens if I miss a dose of ARV’s?

  • Take the medication as soon as you can and take the next dose at the scheduled time (except if the drug may have daytime side effects, in which case you should check with your doctor.)

Where can I go to receive ARV treatment?

  • You can go to your nearest primary health clinic or doctor. If necessary, you will be referred to the nearest HIV treatment site
  • The National AIDS Helpline: 0800 012 322
  • HIV 911: 0860 448 911

Can I take a break from ARVs (like a ‘drug holiday’)?

  • No! Breaks in treatment can cause the HIV to become resistant, and stop the ARVs from working!

If you change to a new ARV, can you go back to the old ones in the future?

  • The decision will depend on why the change was made in the first place and if the virus is resistant to those ARV’s or not.

Why it’s so important to stick to your ARV treatment schedule

ARV treatment doesn’t cure you of HIV, it only helps to keep the infection under control so that you can stay healthy for as long as possible. If you do not take your ARVs as prescribed, you’re putting yourself in danger. Some of the risks include:

1. Your HIV infection may become resistant to the medication – this means that the treatment will no longer keep the infection under control because the virus finds ways to protect itself from the ARVs. Also, you’ll never be able to use that particular medication again – it will not work and please remember that there’re only a limited number of drugs used in treating HIV.

2. The virus will be able to replicate and you’ll end up with a high viral load in your body – a high viral load means that treatment is failing and your body is becoming weak

3. The HIV infection will progress and you’ll become ill. To succeed in treating HIV, it’s up to you to be responsible for your health – take your medication exactly as directed. ARV treatment used to be complicated with many different pills to take, but these days combined pills are available, which means you only need to take one tablet once or twice a day – much easier to remember!

ARVs leave the body quickly, which is why you need to take your medication regularly – ensuring that there is always the correct level of medication in your blood stream working to keep the HIV under control.

As soon as you skip a dose, it gives the HIV a chance to recover slightly, start replicating and learn ways to fight the medication you’re using – scary, hey!

So how can you ensure that you adhere to your treatment schedule? Here’re some tips:

  • Practice first with jellybeans- if you find the schedule difficult to follow then at least you can work with your doctor to iron out issues before you start taking the real medication
  • At the beginning of each week, divide your pills up into daily doses using a pill box – this way you simply need to open up the correct day and drink your tablets. Planning makes pill taking much easier
  • Work your pill taking into your daily routine- for example take them after brushing your teeth and leave your pill box next to the tooth paste in your bathroom cupboard (make sure this is out of children’s reach!)
  • Make sure you do not run short- keep an emergency supply of a few pills for just in case
  • Set an alarm on your phone to go off each day at the correct time to take your tablets

If you find that you keep missing your dose, do not be afraid to ask for help- that is what doctors and other medical professionals are there for, to help you!

You can try and work out together why it is you are struggling – are you having unpleasant side-effects? Your doctor could help you find a way to manage this, or perhaps you need to change to a different drug – not everyone tolerates medications in the same way.

The main goal is to keep yourself as healthy as possible, for as long as possible and by using your medication correctly you are increasing your likelihood of success.

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What is PrEP and PEP?

Ever heard of the acronyms PrEP and PEP? Both refer to HIV prevention; let’s have a look at what these terms mean.

PrEP:

This stands for Pre-Exposure Prophylaxis. Prophylaxis means to “prevent the spread of a disease or infection”. We’re desperately trying to curb the spread of HIV infection and PrEP is one of the newer methods being used – an HIV negative person will take a tablet (containing two types of antiretroviral medication) every day to prevent contracting HIV. This, together with other preventative methods such as condom use, can offer very good protection.

So who would take PrEP? At this stage it is not recommended for just anyone, only for those at high ongoing risk of HIV infection – for example someone whose partner is HIV positive, sex workers and men who have sex with men. This method can also be used when an HIV discordant couple (one HIV positive and one HIV negative) wish to conceive a child. It is important to note that this is not a vaccine for HIV, only a prevention strategy.

How effective is PrEP? Studies so far have been encouraging, with PrEP lowering the risk of HIV infection by up to 90% in some BUT this is only if the medication is taken daily. If compliance is poor, it is much less effective- with some studies showing it to be completely ineffective owing to poor adherence. Currently PrEP is not routinely given in government settings in South Africa- if however you think you are at particularly high risk speak to your doctor to see whether PrEP would be suitable for you.

PEP:

This stands for Post-Exposure Prophylaxis. After someone has been exposed to HIV, PEP can be given to reduce the risk of contracting the infection. This is regularly used in settings such as – after sexual assault and for health care workers if injured at work – a needle-stick injury for example. To be effective this needs to be taken within 72hrs of exposure and consists of 2 or 3 antiretroviral drugs that need to be taken for a month. PEP is NOT 100% effective even when taken correctly and the medication can make you feel quite unwell for the duration of the course.

So who would take PEP? Someone who has been exposed to HIV in a single event which is unusual. It is not to be used in place of condoms and other HIV prevention methods.

How effective is PEP? It is most effective if started within 72hrs of exposure – you will have an HIV test before starting (as it is only given to someone who is HIV negative) and then again at 6 weeks, 3 months and 6 months.

Author: Dr Lynelle Hoeks 

What to eat if you are HIV positive

Good nutrition and a balanced diet is incredibly important for people with HIV, as they have a compromised immune system and are prone to illness and infection. They are also at higher risk for developing other diseases, and may experience common side effects such as fatigue. Certain foods can help people with HIV to feel better, and can boost their immune system so that they get sick less often and are able to fight off infection.

For a lot of HIV positive people who take ARVs, the medication can make them feel ill and nauseous. If this happens to you, then follow the BRAT diet of bread, rice, apple sauce and toast. These foods are gentle on the stomach, but still provide all the nutrients a person needs to help recover faster.

Oranges are also a great natural source of vitamins and minerals, and they’re packed with Vitamin C – an antioxidant which helps boost your immune system. Fresh fruit and vegetables are always the better option, but you can also take a daily multivitamin and mineral supplement to help ensure you’re getting the nutrients you need.

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