The first few months follow a fairly clear path. Here is what to expect.

Key points

• • Treatment is recommended for everyone with HIV, and is best started as soon as possible after diagnosis.
  • Modern HIV treatment is often a single tablet taken once a day.
  • Most people reach an undetectable viral load within six months of starting treatment.
  • Some HIV medicines interact with everyday products like antacids and herbal remedies, so always check with your pharmacist.
    
    

What happens after a HIV diagnosis?

Your first appointments will usually be with an HIV specialist, a sexual health clinic or a GP with training in HIV care. You will have some baseline blood tests. These measure your viral load, which is the amount of HIV in your blood, and your CD4 count, which shows how strong your immune system is. Other tests check your kidneys, your liver and whether you have hepatitis B or C, so your doctor can choose the right medicines for you.

Your clinic can also help you work out whether any partners should be tested, and can do this confidentially on your behalf if you prefer. You do not have to have every conversation at once.

When will I start treatment?

As soon as possible. In Australia, treatment is recommended for everyone living with HIV, regardless of their CD4 count. Some people start within days of diagnosis, sometimes on the same day. Starting early protects your immune system and your long term health.

HIV treatment is called antiretroviral therapy. It does not remove HIV from the body, but it stops the virus from copying itself, which allows your immune system to recover and stay strong.

What does treatment involve day to day?

For most people, treatment is a single tablet that combines several HIV medicines, taken once a day. It is generally well tolerated. Mild side effects such as headache, nausea or an upset stomach can happen at the start and usually settle within a few weeks.

Taking your medicine every day matters. Regularly missed doses can allow the virus to become resistant, which makes it harder to treat. Linking your dose to a daily habit, like brushing your teeth, and setting a phone reminder both help. If you do miss a dose, check your leaflet or ask your pharmacist what to do rather than guessing. For some people, longer acting options may become suitable later, so ask your specialist whether they could suit you.

How will I know it's working?

Your viral load will usually be checked two to four weeks after you start, then every three to four months. Most people reach an undetectable viral load within six months, and many reach it much sooner. Your CD4 count usually rises over time as your immune system recovers.

Once your viral load has been undetectable for six months and stays that way, you cannot pass HIV on through sex. This is known as undetectable equals untransmittable, or U=U, and it is backed by strong research. For many people, it is one of the most freeing things to learn after a diagnosis.

What about my other medicines and supplements?

Many HIV medicines interact with other medicines, including some you can buy without a prescription. Some need to be taken at a different time from antacids and from calcium, iron or magnesium supplements, which can stop them being absorbed properly. Herbal products such as St John's wort, some inhalers and nasal sprays, and recreational drugs can also interact.

The simplest protection is to tell your pharmacist and doctor about everything you take, and to check before starting anything new. Using one pharmacy for all your medicines makes this much easier.

Where can I find support?

You do not have to work through this alone. NAPWHA, the National Association of People with HIV Australia, and state organisations such as Positive Life NSW offer peer support from people who have been through the same experience, along with practical information about living with HIV.

Who you tell, and when, is largely your choice. Many people find it helps to talk it through first with a counsellor, a peer support worker or their clinic. Looking after your mental health is part of looking after your HIV.

How Ace can help

Staying undetectable depends on taking your medicine every day without gaps. Ace dispenses HIV medicines and delivers them to you, and our pharmacists can check any new medicine, supplement or over the counter product against your treatment before you take it. Get started with Ace.

References

healthdirect. Antiretroviral treatment for HIV.

healthdirect. HIV infection and AIDS.

ASHM Health. U=U: ASHM guidance for healthcare professionals.

Positive Life NSW. Managing your HIV.

NAPWHA. HIV treatment for all.

This article is for general information only and does not constitute medical advice. Your HIV treatment should be guided by your HIV specialist or prescribing doctor.