When is a good time to start thinking about and taking medications?
For HIV positive individuals, this can be a very difficult decision to make. HIV/AIDS affects everyone’s body differently. Some individuals can go years without needing medications and others are recommended to start medications right away. Regardless of how medications come up, it is an inevitable decision and conversation that an HIV positive person should address. Long term medical adherence to prescribed medications is something that cannot be ignored; currently it is the recommended method for managing HIV/AIDS.
After being diagnosed with HIV/AIDS, a doctor would prescribe a Highly Active Antiretroviral Therapy (HAART) regimen for their patient. This recommendation comes after a doctor runs labs to test what medications the person’s HIV virus is reactive or non-reactive to. The recommendation to go on medications by your doctor is based on your viral load and CD4 cell count. If your CD4 count levels are higher and viral load low usually (this is an ideal situation) and time might be allotted to patients if their CD4 levels are high above 350.
Every doctor believes something different; some believe in having patients start antiretroviral therapy when their CD4 count is between 300 and 500. Others believe that starting patients on HIV medications when their CD4 count is about 500 is best. Lastly some doctors believe starting any new patient diagnosed with HIV within 3 to 6 months of infection on HIV medications right away regardless of CD4 levels. It depends on you and your medical provider to decide and create the regimen that works best for you. Unfortunately some individuals might have more options than others when it comes to what types of HAART one can take, but it is important to understand your care and what it means. It is important to discuss with your doctor how you feel throughout each stage of your care. At this current point in time a cure is not available; however, HAART is allowing PLWHAs to live longer and healthier lives.
Proper medical adherence, meaning taking medications consistently and as regulated, is the key to survival and effective treatment.
Here are some questions to help navigate your decision process:
- Are you mentally and emotionally ready to take medications when your doctor recommends them? Have you communicated with your case manager or doctor about if you are ready?
- Starting medications is a lifelong commitment. Do you understand the long term and short term outcomes?
- Do you know what regimen will work for you? Look at your schedule and lifestyle, and discuss with your doctor what regimens are going to work well with your life. (For example, some medications are one pill a day or multiple pills, or several times a day. Which are you most comfortable with and fits in your schedule? What types of medications you might be interested in?)
- Some medications have different side effects; how are you going to manage the side effects if there are any? (I.e. Atripla can affect sleep or make one sleepy; how would you manage this?)
- How are you going to pay for medications? (I.e. Insurance, rebates, Ryan White, etc.)
The goal is to successfully manage HIV/AIDS so that individuals can live longer and better lives. Treatment is prevention. Adhering to medications effectively (meaning close to 100% of the time) significantly reduces rates of transmission to about 96% percent.
PLWHAs can play a role in helping to end this epidemic by making sure that they are taking care of their bodies and managing the disease. When medications are not taken properly, doses are missed or late etc., the chances for the virus to mutate and render those medications ineffective increases along with the possibility to transmit the virus to others. This means that an individual might have to find a new medical regimen, which can be a difficult process and limit the options of medications available. The ability to live a long healthy life depends on the individual; this is why it is important when deciding to take medications that one understands the road ahead. No one else can take a pill for you, and only you know how you feel. Make the best decision you can for yourself, hopefully you will be ready and prepared for the journey ahead.
The HIV/AIDS epidemic impacts persons regardless of sex, age, race/ethnic group and/or geographic region in Ohio, but the impact is not the same for all population groups. The HIV epidemic continues to change and the number of persons living with a diagnosis of HIV infection continues to grow, it is important to identify populations most impacted and at greatest risk for HIV infection in order to equitably allocate resources for HIV prevention and care initiatives.3
March 20th, 2012 marks the 6th annual National Native HIV/AIDS Awareness Day (NNHAAD). NNHAAD is a national mobilization effort designed to encourage Natives (American Indians, Alaska Natives and Native Hawaiians) across the U.S. and Territorial Areas to get educated, tested and involved in prevention and if need be get treated for HIV and AIDS. NNHAAD is a federally recognized awareness day founded in 2007 and is funded by the U.S. Centers for Disease Control and Prevention.1
American Indians and Alaskan Natives represent 1.5 percent of the total U.S. population; however, the population ranks third in terms of the rate of HIV/AIDS diagnoses. According to the CDC, by the end of 2008, the HIV infection rate was 22.8 per 100,000 persons for Native Hawaiians/Other Pacific Islanders (NHOPIs) and 11.9 per 100,000 for American Indians/Alaska natives (AI/ANs). Furthermore, the Native population tends to have higher mortality outcomes after diagnosis in comparison to other racial and ethnic groups, exemplifying the health disparities faced by this population. Social determinants such as socioeconomic issues, cultural diversity in prevention efforts, substance abuse and testing issues may have an impact on observed rates. 1
Even though the numbers of HIV/AIDS diagnoses for American Indians and Alaska Natives represent less than 1% of the total number of HIV/AIDS cases reported to CDC’s HIV/AIDS Reporting System, when population size is taken into account, American Indians and Alaska Natives have had a higher rate of diagnoses than Caucasians since 1995.2
For more information on National Native HIV/AIDS Awareness Day or on HIV/AIDS visit www.nnhaad.org
1. ‘Increase in Rate of HIV Diagnoses among Native Communities Further Emphasizes the Need forEnhanced Prevention Efforts’ The AIDS Institute 3.20.12 2. ‘HIV/AIDS among American Indians and Alaska Natives’ CDC HIV/AIDS Fact Sheet 3. ‘Ohio HIV/AIDS Epidemiologic Profile – 2011 Edition’ Ohio HIV/AIDS Surveillance Ohio Department of Health
As a young woman working in the HIV/AIDS community, I admittedly forget sometimes how fortunate I am to work with and for so many powerful women. Throughout my tenure at OAC, I have listened to many stories of mothers, daughters, friends, partners, and women living with HIV/AIDS. All of these women have something to say, and today, we honor all of these women on National Women and Girls HIV/AIDS Awareness Day.
According to the 2010 Census, 51.2% of Ohio’s population is female. 23.7% of Ohio’s population is under the age of 18. 38% of Ohio females are under the age of 30. Moreover, approximately 12% of Ohio’s population is Black/African American. Yet, when you look at Ohio’s population more carefully, you see that Black/African American women and youth are still disproportionally impacted by HIV/AIDS.
The Ohio Department of Health’s HIV Surveillance found 1,033 new HIV diagnoses in 2010. Of those new diagnoses, 17% were female, 33% were between the ages of 20-29, and 49% were Black/African American. Heterosexual contact is still the leading mode of transmission for HIV positive women. And when it comes to perinatal transmission, transmitting HIV from mother to child, 100% of all reported AIDS cases in Ohio are among children are under the age of 13.
So what do these numbers mean? It means that young women in Ohio are still becoming HIV positive. It means that all pregnant women should be tested for HIV/AIDS so as to prevent vertical transmission. It means that our programs must be culturally appropriate for young African American women. It means that our mothers must teach their daughters how to love themselves and protect themselves against sexually transmitted infections. It means that we need to consider all women’s roles (e.g. mother, student, friend, etc.) when scheduling programs.
As a young woman working in the HIV/AIDS community, it means that I have a lot more work to do. It means that I have a lot more stories to hear and many more lessons to learn. It means never taking for granted the women who came before me and the women who will become my future friends and coworkers. It means that we all need to listen to women and validate their journey with HIV/AIDS. On National Women and Girls HIV/AIDS Awareness Day, it’s time to listen.