Starting HIV medication used to be a very simple proposition in the late ’80s and early ’90s. Many people would do their utmost to delay starting treatments by endeavoring to maintain a positive outlook and healthy lifestyle. However, eventually overwhelming physical symptoms caused by the natural progression of HIV and guidance from a compassionate doctor would dictate that it was time to start medication.
The alternative to accepting the path of starting HIV treatments was to experience the rampages of opportunistic infections and eventually death. Some individuals took measures to depart life early, and suicide was not an uncommon occurrence. So even though first generation HIV medications were considered by many to be toxic, people are grateful to be alive and to love, fight and hope for better days. However, some individuals have remained in a ‘delay in every way’ anti HIV medication culture with detrimental impacts on their health.
In 2011, we now have available to us second and third generation HIV medications. Often this has meant that the pill burden has been reduced, as well as the most severe side effects. HIV medication regimes are increasingly being tailored to the individual’s lifestyle and other factors. So given that life expectancy is now approaching normal, saving yourself from two to four years out of forty plus years of pill-taking could be disadvantageous, when you consider the loss of immunity, immune function and regulation, ongoing complication through HIV inflammation and increased infectiousness.
International guidelines (e.g. USA) are now indicating that people should start taking medications when their CD4 cell count falls below 500 rather than the previous recommendation of 350 CD4 cells. One of the considerations to starting earlier is if a person is in a ‘Pos-Neg’ relationship. This acknowledges the massive reduction in infectiousness when someone with HIV reaches and maintains an undetectable viral load in the blood (which is the amount of HIV measured in the blood) as a result of being successfully on HIV medication.
One of the biggest obstacles to starting treatment is psychological. For some people there is a notion that ‘once I start medication, I can’t stop’ or that ‘taking pills reminds me of HIV everyday’. Personally I overcame this by choosing to believe that the pills before me were an expression of the community’s love of me and the value it has in preserving all life with dignity. With this in mind, taking a pill everyday brings a smile to my face. Naturally your obstacles to starting treatment may be different, as is the potential solution.
So I encourage you to engage with a counsellor and other support structures available to you including the WA AIDS Council.
Ultimately the decision to start HIV treatment remains a respected personal choice made in consultation with your HIV specialist doctor.
Contact Lifeline on 13 11 14 or Suicide Call Back Service on 1300 659 467 if you are in need of immediate assistance or talk to someone you trust, your GP or your local health professional.
Cipri Martinez
WA AIDS Council
***
