Strategies for first line HIV therapy

May 2008     View PDF

Starting therapy in women

For the most part, the recommendations for when and what to start are the same for women and men. If a woman is not pregnant, not planning to become pregnant and not taking hormonal contraceptives, by and large their treatment recommendations are the same as for men. While HIV drugs have not been studied as extensively in women, most evidence to date shows that they work as well for both. There are two special considerations for women considering Viramune. See the NNRTIs section for this information.

The Guidelines recommend that all HIV-positive pregnant women be on HIV therapy, regardless of their CD4 counts or HIV levels. Some doctors recommend that they wait to begin treatment until their second trimesters (13–24 weeks). Since the first trimester is when the baby’s major organs develop, this is when birth defects from taking medicines will most likely occur. Some HIV drugs should NOT be taken during pregnancy, which are discussed in the next section. (For more information, read Project Inform’s publication, Pregnancy and HIV Disease.)

Some HIV drugs interact with oral contraceptives or other female hormone replacement therapies. So it may be necessary to adjust the dose of the oral contraceptive, use other methods of birth control, or change your HIV drugs. You can discuss these interactions with your health provider or pharmacist.