Treatment...

Treatment is highly individualized and specific to each person living with HIV or AIDS. Treatment decisions are based on many factors, including, but not limited to: preexisting conditions, CD4+ levels, viral load levels, potential drug interactions, potential side effects, drug resistance testing, adherence potential, pregnancy or pregnancy potential, and convenience (pill burden, dosing frequency, food and fluid considerations).

For many years, treatment has been recommended for those people whose CD4+ drops below 350. In the past few years, there has been a shift to a recommendation for treatment for anyone whose level drops below 500. Now, in very recent years, many physicians are again shifting to say that it may be most beneficial to start treatment immediately after HIV diagnosis for all, regardless of CD4 levels. The jury is still out on this though, and it is not yet the official recommendation.

Now, with my situation, things were a bit different. Because I went through acute seroconversion and received a diagnosis within one month of being infected, I am a bit of a rare case. And with that comes some more not so clear/concrete recommendations about treatment. Basically, it is "thought" (and currently being researched) that if one can catch and attack the virus with treatment during such an early stage, there may be some extra benefits.It may help to establish a higher CD4 set point and get to an undetectable viral load quicker. It may also prevent the virus from getting down into some of its deepest darkest hiding places. It may prevent some of the inflammation and damage to organs that can happen in the first few months of infection. The one obvious disadvantage is just that you start on treatment right away and are on it for the rest of your life.

After researching and talking to doctors for about a week, I made the very difficult decision to go ahead and start treatment. We discussed drug regimen options, but I kind of knew all along (from my research) what I wanted. We chose Atripla- the number one recommended and preferred treatment currently available. Atripla is a combination of three medicines in 1 pill. Efavirenz/Tenofovir/Emtricitabine (EFV/TDF/FTC). It is a 1 pill a day solution- effective, convenient, and damn expensive!

After 1 week on Atripla, I had noticed some of the side effects, but nothing too serious. Just a little bit of drowsiness or drunken feeling. But, by the end of my first month taking it, I no longer felt those side effects. Most peoples bodies will adjust to the medicine and overcome the minor side effects.

Picking up the meds at the pharmacy and preparing to take that first pill was definitely one of the hardest days so far. It made it REAL. As my therapist reasoned, "It's been real all along, but invisible. You know you are changed. You know you have this virus inside of you. But you can't see it. You can't touch it. But a pill is real. It is the real physical manifestation of this disease that you'll have for the rest of your life." And the pill is going to be there everyday to remind you of that!

I dreaded taking that first pill. I sat with my roommate and said "Should I take it? Should I not?"- holding it in my hand and bringing it to my mouth, but then back down again. Finally, I popped it in and swallowed. You just have to do it. No going back. There is only forward.

To make my nightly ritual easier, my roommate helped me decide on a time (10:00pm)- and I set a daily alarm on my phone. We listened to every ringtone available and picked the one that made us laugh and put us in a good mood. It is called "Growl" and I have no idea what it means. But for now, it fits.

My advice if you are trying to make a decision about treatment: Research. Read. Listen to your doctors. But know your stuff too. Don't go with something you are not comfortable with. This is your life. This is your body. YOU must decide what is best for it. Make your decision and stick with it. There is no going back. There is only forward.