Most docs advise you not to start an STI until you’ve been undetectable for a year, with CD4s above 350 for six months. Expect a break to make CD4s drop and viral load rise—sharply but briefly. San Francisco STI taker Timm Dobbins says, “Be comfortable with fluctuating lab numbers—but be monitored.”
Research reveals that STI success has little to do with which drugs are in your combo. Two possible exceptions: Taking hydroxyurea, an immune-suppressing med (used in some bold HIVers’ combos) for several weeks pre-STI may lengthen the break; if 3TC is in your combo, dropping everything but may work better than breaking from the whole regimen—maybe because 3TC-induced resistance puts extra pressure on HIV.
Though on holiday, you’ll still have work to do. Jon Kaiser, MD, a San Francisco AIDS specialist, says “aggressive support of the immune system: healthy diet, vitamins and minerals, stress reduction and exercise” makes a “dramatic difference” in STI results.
Above all, confer with Doc before, during and after to ensure a safe trip.