“The biggest thing isn’t the side effects. Failure to adhere to the meds is the number one reason people fail to live long term. Eventually that’s what’s going to kill you. That’s when you’re going to have problems. You don’t skip days; you don’t forget.” —Joshua Sacks, Washington, DC, Diagnosed: 2004
HIV will trick you (and your treatment) if it can. Given the opportunity—especially if you miss doses and therefore don’t keep a steady level of a drug in your blood—the virus will develop resistance to it. Next thing you know, the drug has stopped working, your viral load is on the rise, and you're looking around for a new combo.
The problem with this is that there are only so many HIV meds to run through.
Key to making the most of your combo is adherence—your ability to take your HIV meds exactly when and how they’re prescribed. Studies show that HIV meds work best when you stay on schedule at least 95 percent of the time.
Certain meds are more forgiving, because they stay in your blood longer, leaving more room for an occasional late dose. But not everyone has that option (ask your doc!).
Eight great tips to help you find meds that work for you—and stay on them:
1. Consider your lifestyle. Do you work the late shift? Travel all the time? Are you a party animal? If you're not sure you can stick to two doses a day, ask your doctor about once-daily regimens. If you don’t eat on a regular schedule, don’t try meds that require food.
2. Take a break when you start. The most intolerable side effects tend to come—and go—within the first six weeks. Try co-coordinating your drug debut with a work break. With some luck, you'll be OK anyway and have yourself a vacation.
3. Don't tolerate the intolerable. Soldiering on when you feel horrible or notice a big change, like a severe rash, fever, flu-like symptoms or muscle aches, is not what the doctor ordered. Call your doc for a combo consultation.
4. Use a beeper or alarm to help you remember to take your meds. Some people find them really helpful, others just plain annoying.
5. Ask a friend to call you at dose time. This can be particularly helpful in the first few days.
6. Pack an emergency dose or two. You never know what might come up.
7. Protect your privacy. For those choosing not to let family members or office-mates know they have HIV, discrete pill-carriers of all sizes, shapes and styles are available. Although your best bet may be something not intended for pills at all.
8. Be prepared if you travel. Pack meds in a carry-on luggage in case the airline loses what you check. Time zones can be accommodated without too much panic by taking doses slightly closer together (if flying west to east) or further apart (if flying east to west). Check with your doc.
WARNING! Party drugs pose two problems. First, your meds are likely the last thing you think about when you're high, so take them early if you plan to go flying without a license. Second—and this is serious—party drugs may interact with some of your HIV drugs—in particular, are protease inhibitors (and especially Norvir and Kaletra), which may bump up levels of drugs like ecstasy, Viagra and GHB in your body to very dangerous levels.
Many other medications may also interact with your combo, so make sure your doc (or docs) is aware of everything you’re taking, including herbal treatments.
When meds fail
This is when HIV just sits there and laughs at your meds or comes bouncing back after a long treatment triumph. First, be clear with yourself about what’s happened: You didn’t fail; your meds did. They didn't suit you. Make sure your doc gives you resistance tests to help you both figure out the best next combo that will work for you.
Meanwhile, find someone to talk to about all your treatment issues at POZ Mentor.