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.
I have been thinking about changing off of Atripla. I have been doing
well on it and not experiencing any side effects...until I started
teaching again and have to wake up and get to work so early in the
morning. Some of the effects of Atripla are that it can make you drowsy
and also give a nauseous/dizzy/drunk feeling. This is why it is
recommended to take it at night, so that you sleep through most of the
side effects. However, if you wake up early in the morning, it is
possible for some people that these side effects have not completely
worn off yet. So, for the past couple months, I have been feeling very
tired and nauseous in the morning, and it really is not very pleasant to
have to go to school and start teaching each morning while I feel like
I'm about to puke. Anyways... my new doctor was also very interested in
switching me off of Atripla for some other reasons... basically that it
interferes with MANY birth control products, and is also not safe for a
baby if I was to get pregnant. She was very adamant that she would have
never started a female my age on Atripla to begin with.
with all that being said, I have now switched to a new medicine. It is
called Stribild, and is a 4 in 1 combination pill. Here is some info
about it if you are interested stribild.com.
I still take one pill a day, and I am choosing to continue taking it at
night (even though I could take it at any time of the day). I will now
have to take it with dinner (as opposed to Atripla, which I had to take
on an empty stomach before bed). So far, I do not think I have any side effects from it.
I am still taking Stribild. I have not experienced any side effects at all, and it continues to keep me healthy!
I am 28. White. A Female. And a former Peace Corps Volunteer. I am HIV Positive. This is my story of how a few months, a few people, and a few events in Zambia changed me and my life forever. This is the story of how I contracted HIV and brought my Peace Corps Journey to a crashing halt... and how I am working now to pick up and put back together the pieces of my life as a newly diagnosed person living with HIV. This was not the journey I had originally planned... my path has traumatically and dramatically changed... but it is the one I am on now. There is no going back. There is only forward. I welcome you to follow along with me as I attempt to explore this new life ahead of me, whether you are someone from the Peace Corps community, or someone living with HIV. I welcome your comments, questions, suggestions, and opinions. Let us go forward together. To start from the beginning, click here He Gave Me More Than A Bracelet.