Learning that you are HIV-positive can be one of the most stressful and anxiety-filled times in your life, but it's not a death sentence. Although there is no cure for HIV infection, there are many treatments available that can help control the disease.
When you first find out that you have HIV, you'll need to adjust to this significant change in your life. Family members and friends might be able to help you, or you could talk with a counselor or a support group. Take your time to educate yourself and consider these four steps:
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Learn more about HIV disease
HIV is a virus that can reproduce rapidly in your body. Without treatment, HIV can weaken your immune system. If this happens, you might get an
opportunistic infection, caused by common germs or microbes. People with healthy immune systems can be exposed to these germs or microbes and not become sick. But in people with weakened immune systems, they can cause serious illnesses.
You will probably have a lot of questions about HIV. There are many good sources of information, including:
Monitor your immune system
In addition to your regular medical exams, there are two special blood tests to keep track of HIV disease. They are the
viral load test and the
CD4 cell count. The viral load test helps show how strong the HIV virus is in your body. It measures the amount of HIV in your blood. Lower levels are better. This test is used to help decide when it's time to start HIV treatment, to see if the medications are working and to know when to change medications.
The CD4 cell count helps show how strong your immune system is. It counts how many infection-fighting white blood cells you have. These cells are also called T cells or T-helper cells. The more of these cells you have, the stronger your immune system will be. If your CD4 cell count gets too low, you might develop an opportunistic infection. This test is used to help decide when it's time to start HIV treatment or medicines to prevent opportunistic infections.
Your healthcare provider will probably want to do these two tests every three to six months.
Develop a plan to deal with HIV
HIV may not be the only health issue you are currently managing. The better your health is overall, the better you can deal with HIV. Work with your healthcare provider to develop a plan that takes into account all of your health concerns.
As part of your planning, you may want to consider getting regular medical and dental checkups, and seeking medical advice or treatment for conditions like diabetes, high blood pressure or high cholesterol. In addition, if you can avoid smoking, drinking too much alcohol, recreational drug use and sexually transmitted diseases, you will probably find your HIV easier to manage.
A critical consideration of your plan will be deciding when to start taking medications and which ones to use first. Take the time to gather the latest information on treatments and work with your healthcare provider to decide what
treatment regimen may work best for you and your lifestyle. You might choose to use HIV medications very early in your disease or you might decide to wait until you reach specific viral load or CD4 cell levels. It's up to you, working in partnership with your healthcare provider.
Remember, you are in charge of your own health care. You will decide which healthcare provider to work with to decide which treatments you use and when you want to use them. Take your time and learn about your options.
Consider treatment
Current HIV medications can help HIV-positive people stay healthier longer. But starting treatment is a big decision. In order to get the maximum benefit from the medications, you need to make a commitment to taking them properly. Commitment to the treatment is as important as the medications themselves.
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 The risks and benefits of delaying treatment
Risks of delaying treatment:
- May have immune system damage that cannot be reversed or improved
- Greater chance of progression to AIDS
Benefits of delaying treatment:
- Avoid drug-related side effects
- Avoid negative effects on quality of life
- More treatment options for the future
- Reduced chance of treatment fatigue
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Leading medical experts and public health officials have put together a list of guidelines to help determine when to start treatment:
- Anyone with symptoms of advanced HIV disease (such as opportunistic infections), or with a diagnosis of AIDS should start treatment
- Anyone with a CD4 count less than 200 should start treatment (those with a CD4 count between 200 and 350 may also consider treatment)
- People with a CD4 count greater than 350 and viral load less than 100,000 should delay treatment
The guidelines are less clear in other situations. You and your healthcare provider should review your numbers frequently and consider the risks and benefits of starting treatment earlier or later.
