Strategies for first line HIV therapy

May 2008     View PDF

Some questions to answer
before starting first line therapy …

What is your current CD4 cell count?

• Overall, what is the trend? Increasing? Decreasing? Stable?
• Is it above 350, below 200, or in between?
• Are you aware of the health risks related to a count below 200?

What is your current viral load?

• Overall, what is the trend? Increasing? Decreasing? Stable?
• Is it below 10,000 or even undetectable?
• Is it above 55,000 or steadily climbing on two or more tests?

Are you ready and willing to commit to therapy?

• Have you taken medicine that you had to take on time every day? Was that easy or difficult?
• What situations might make you miss a dose?
• Do you want privacy and in what situations?
• Can you keep your medicine with you through­out the day? Where’s best place to store it so you can get to it and not forget to take it?
• Does your doctor’s office, clinic or local AIDS organization offer services to help you take your meds as prescribed?

Are you aware of the possible side effects?

• Do you know what side effects may give you the most problems, like nausea or diarrhea?
• Are you aware which may happen only within the first week or so and are likely to get better over time?
• Are you aware of the signs of more dangerous or long-term side effects? Do you have another regimen to switch to?
• Do you know what you can do to help avoid or lessen them? (Read Project Inform’s publication, Dealing with Drug Side Effects.)

Do you know which therapies may preserve more options for later?

• Have you considered what your second, and perhaps third, regimen will be if your first doesn’t work?
• Have you read about the drugs that are being studied and how they may be used?
• Do you want to start with the most potent combination, or would you rather save those drugs for later?

How do you feel about therapy?

• Do you feel confident that starting now is right for you? What makes you feel this way?
• Are you anxious or worried? Have you talked with your doctor about your concerns?
• How do feel about specific drugs? What might help address your concerns?

Are you aware of how therapy may impact your life?

• How do you feel about taking pills every day, perhaps for the rest of your life? What support do you have to help you through the difficult times?
• In the first days after you start therapy, what support and flexibility do you have with commitments like work, taking care of children or volunteering?
• Will starting treatment limit you taking part in activities that you enjoy?
• How do you plan to carry your meds with you? If you’re away from home overnight, on vacation or in places that are awkward for taking them?