If you are living with HIV, one of the biggest lifestyle changes is starting ART and taking treatment for the rest of your life. If you want to stay strong and live a healthy life, you can never stop your treatment. Your body might take some time to adjust to the side-effects of the ARVs, and you will need to remember to always collect your pills in time, so you don't run out, and you have them with you when you need them so you can take your treatment at the same time every day.

What Adherence to ART means

Adherence to Antiretroviral therapy (ART), or taking ARVs exactly as the healthcare worker advises, leads to viral load suppression. This is when ARVs have reduced the amount of HIV in the body so much that it is suppressed and the immune system gets a chance to recover. At this stage, there is so little HIV in the blood that there is less chance of passing it on. Someone living with HIV will also be able to have HIV-negative children by following the correct procedures. Although taking ARVs may be feel like a burden, stick to the treatment. When HIV is suppressed a long, happy, healthy and productive life is achievable.

For ART to be effective it needs to be taken as prescribed by a healthcare worker. This means:

• Not taking breaks from taking ARVs
• Avoiding skipping doses.
• Taking ARVs around the same time every day. Not doing so is as bad as skipping a dose.
• Taking ARVs with a healthy meal or on an empty stomach depending on the advice from the healthcare worker. This affects how well the ARVs are absorbed into the body.
• People living with HIV should try to avoid taking other medication that might interfere with their ARVs. It is best to discuss other medicines that are being taken with the healthcare worker at the clinic, even simple pain killers. This includes telling the healthcare worker about any drugs taken socially to get high or alcohol.

Click here for First-line ART Regimens.

Why adherence to ART is important

Achieving Viral load suppression

Viral Load Suppressionis when the amount of HIV in the blood has dropped so much - to less than 50 copies of HIV in a teaspoon of blood - that it cannot be detected by a viral load test. This does not mean that HIV is cured but that there is only a small amount of HIV in the blood. If ART is skipped or stopped HIV will take the chance to grow stronger and attack the immune system again. Viral load suppression is the aim of ART and can only be achieved if you take your ARVs.

Avoiding Drug resistance

When someone first starts taking ARVs they start on first-line treatment. If ARVs are skipped or stopped, HIV multiplies again. When HIV multiplies, it changes its form and makes different versions of itself. HIV can now trick the first-line treatment because the ARVs don't recognise the new HIV. This is how HIV becomes resistant to first-line treatment. Because first-line treatment no longer works to control HIV, second-line treatment is needed. Second-line treatment is stronger and has more side effects. Skipping or stopping on second-line treatment means HIV could become resistant to this treatment too. Third-line treatment is even more complicated, has more side effects and leaves the person with almost no treatment options.
Treatment can only be switched upon instruction from a doctor or a nurse.

Tips for taking ART

Taking ART is a lifelong commitment and that might feel overwhelming sometimes. But there are real steps people living with HIV can take that can help them take their ARVs every day, at the same time, to keep HIV under control and reach viral load suppression:

• Use a 7-day pill box to keep ARVs organised. Make time once a week to refill the box for the week ahead.
• Setting an alarm, or a reminder, on a cell phone and taking the ARVs straight away when it goes off.
• Setting a reminder on a cellphone or using a wall calendar as a reminder to return to the clinic for more ARVs a week before the medication runs out.
• Choosing a regular daily activity to help remember to take the ARVs, like brushing teeth, or when a favourite TV show starts.
• Keep a treatment diary. Enter the name of each ARV. Include the dose, number of pills to take, and when to take them. Record each ARV as it is taken.
• Plan ahead for changes that might be coming up, like weekends, going home or going on holiday. The person taking ART should make sure they have enough ARVs to last the whole time they are away.
• Get a reliable treatment buddy - someone who can remind the person to take their ARVs.
• Disclosing - telling someone about their status - can help that person feel loved, accepted and supported.
• Join or start a support group for people living with HIV. These can be based at clinics, churches , schools and colleges.
• Join an adherence club at your clinic or in your community.

Side effects and ART

ARVs can have side effects. Side effects differ from person to person. Mostly they stop after the first few weeks. If you have bad side effects that last for more than 7 days, do not stop your treatment. It is best to speak to a healthcare about steps that can be taken and medication that can manage the side effects. Sometimes the healthcare worker will swap an ARV in the treatment regimen for a different one that the body handles better.

These are the most common side effects of the ARVs that are available at our hospitals and clinics:

Managing side effects

There are medications to manage some of the side effects common to ARVs, but there are also foods or steps that can be taken that can help. People taking ART should not take any herbal remedies without consulting a healthcare worker.