HIV treatments

Updated on:
July 31, 2021

Are there currently treatments available for HIV?

Yes! While HIV treatments do not completely eliminate (cure) the infection, they can successfully manage it so HIV positive people can live healthy lives. HIV Treatment is also called: combination therapy, antiretroviral therapy (ART), HIV meds, etc. It involves taking a combination of drugs to keep the virus suppressed and the body healthy.

HIV treatment usually includes three different drugs combined into one pill that is taken daily. There are many combinations of treatments available, making it very likely that somebody will find a treatment that works for them with little to no side-effects.

What are the treatment options for HIV?

There are three main drugs used in HIV treatment, two of them are nucleoside analogues (nukes) and the other one is from a different class. The main types of drugs used in HIV treatment are: integrase inhibitor, protease inhibitor, and non-nukes; among others that are used in more special cases. Visit Catie if you’re looking for a breakdown of the different types of drugs, or a list of commonly prescribed HIV treatments in Canada.

The ideal treatment will: suppress your viral load, restore your immune cell counts, cause minimal side effects, and be easy to take. Your healthcare provider will work with you to find the optimal HIV treatment for you.

How urgent is treatment for HIV?

The earlier somebody starts treatment for HIV, the less negative impacts on your body the virus will cause. It’s important to ensure treatment is in place as soon as possible after a diagnosis. Starting HIV treatment right away is paramount when one of the following conditions is present: pregnancy, early HIV infection, and most AIDS-defining conditions.

What happens if I don’t get treated?

If you do not get treated for HIV, your viral load will progressively increase, and your immune system function will progressively decrease. The speed at which that can happen varies widely from person to person. Without treatment, somebody can develop AIDS, which indicates a compromised immune-system and can cause cancers and life-threatening infection.

How accessible are HIV treatments?

Access to HIV treatment does vary province to province and requires access to a healthcare provider who can prescribe the medications, a clinic, a lab for bloodwork, and coverage for the medications. Luckily, these things are not an issue for a majority of Canadians.

To cover the cost of treatment, most people rely on drug insurance plans or provincial or territorial plans. Some people, like refugees, members of the military, federal government employees and retirees, federal prisoners, and Indigenous people living on reserve can access treatment though the federal government.

If you have private insurance, contact them to find out which antiretroviral drugs are covered under your plan and what the terms of coverage are. Most provinces and territories include HIV treatment in their public drug formulary, however there may be some restrictions and exceptions. There are programs that can support access to free HIV treatment; please contact your local HIV organization for more information.

When should I begin treatment for HIV?

There are many benefits to starting HIV treatment early. The earlier somebody is diagnosed, the less time HIV has to impact the immune system. Starting treatment early can reduce the risk of developing serious infections and cancers.

Is it discreet?

Treatment is discrete; only healthcare providers directly involved in your medical care will know about your diagnosis. Public health officials will request that you report any partners who you may have exposed to HIV, but the contact tracing is done by medical providers and without releasing any personal information about you.

How much do HIV treatments cost?

If you have private insurance, contact them to find out which antiretroviral drugs are covered under your plan and what the terms of coverage are.

Most provinces and territories include HIV treatment in their public drug formulary, meaning their cost is completely covered; however, there may be some restrictions and exceptions. Fortunately, there are programs that can support access to free HIV treatment so please contact your local HIV clinic or organization for more information.

Can I have sex during my treatment for HIV?

Until the viral load of an HIV positive person is suppressed, there is a chance of transmitting HIV. People who have been diagnosed, and reached an undetectable viral load, cannot transmit HIV to their sexual partners. Masturbation and oral sex pose little to no HIV risk, which can be safer options than penetrative sex while treatment is initiated and the viral load is still elevated.

Usually, it takes three to six months for somebody’s viral load to become undetectable on repeat testing. This timeline can vary for each individual. 

What are the risks to my partners if I don’t wait?

Having sex, sharing drug use equipment, getting pregnant, and breastfeeding can pose a risk of HIV transmission if your HIV viral load is detectable on lab testing. Once somebody achieves a suppressed or undetectable viral load, there is no risk of transmission through sexual contact and significant decreases in the risk of transmission through other methods.

Do I need to communicate this to my partners? If I choose to, how should I?

It’s important to have honest and open communication with your partners about your sexual health, STI, and testing history. If you haven’t been tested in a long time, have any symptoms, or have detectable HIV, it’s important to tell your partners.

If you’ve been medically advised that your HIV infection is undetectable, you can no longer transmit the infection to sex partners. It’s your choice whether or not to tell your partner about any of your diagnoses. Currently, HIV non-disclosure laws can be challenging, you can read more about it here.

How can I be sure the treatment for HIV is working?

Your healthcare provider will inform you about your HIV viral load. As part of living with HIV, you will need to get your blood drawn at the lab every few months - especially in the beginning of treatment - that allows for viral load and CD4 testing. Your CD4 count may be checked less often once it is in the normal range and your viral load is suppressed.

Will any symptoms cease to exist?

Many people who feel ill due to their HIV infection will feel better after beginning treatment.

What do you do if the treatment doesn’t work?

Frequent viral load tests will ensure that you and your healthcare provider know whether treatment is working or not. If your viral load is not decreasing or has increased, your healthcare provider will work with you to find out why and may need to change your treatment. Due to the large variety of treatment combinations, most people find a treatment that works for them fairly easily.

Will my treatment stop working?

As long as you continue to take your HIV treatment as prescribed by your doctor, the treatment should continue to work. It is only when there are missed doses or other issues with the amount of medication in your body that the treatment might not continue to work. This is another reason that continuing to see your healthcare provider and getting regular lab work to check your HIV viral load is so important. 

Should I stop my treatment?

The only way to prevent the many complications of HIV infection is to continue on treatment.

If you are considering stopping your HIV treatment, it is best to talk to your healthcare provider before doing so as they will try to work with you to find a strategy that can allow you to continue treating your HIV.

Reviewed by:
Dr. Caley Shukalek

Caley is passionate about evidence-based, patient-centred care, including telemedicine that can provide high quality care from wherever a patient may choose.

He helped create Alberta's PrEP guidelines and works as a specialist in General Internal Medicine with additional training in sexual health, including HIV and sexually transmitted infections.

He holds an Masters of Public Health from Johns Hopkins University, an MD from the University of Calgary and an MSc from the University of Alberta.