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Yes, when it comes to treating HIV we seem to talk a lot about pills and blood work. But these are the things that you probably deal with most. They’re also the things that can help you stay healthy over many decades. Most people who are on treatment will face the issues listed below at one time or another.

“BLIPS” ON VIRAL LOAD
The point of taking HIV medications is to keep HIV at an undetectable level. But it’s common for people to have a low, detectable result on their viral load tests every now and then (up to 1,000 copies). This called a blip and several things can cause it: you’ve had another recent infection like the flu, the test gets mishandled in the lab, or you’ve gotten a vaccination.

Blips are usually nothing to worry about. They’re often temporary and usually a sign that the immune system is working harder to control more infectious bugs. Follow up with another test to see if it’s back to undetectable.

CLUES TO GENERAL HEALTH
People often focus a lot of their attention on their HIV blood work. But it’s just as important to review your other test results, such as liver and kidney proteins, blood sugar, cholesterol and Pap smear results. If these results change over time, you could develop certain conditions like diabetes or cancer. Learning what all your test results mean—not just the ones about HIV—can help you feel the best you can.

MAKE SURE YOUR MEDS GET ABSORBED
HIV meds can do their job only if your body has a chance to absorb them properly. Getting them into the bloodstream where they control HIV has a lot to do with what you eat and drink. Talk to your provider or pharmacist about ways to deal with these:

• Some HIV pills should be taken with food to work well; others are taken on an empty stomach.

• Antacids (both over-the-counter and prescription) can change stomach acid so it doesn’t break down meds as well.

• Grapefruit and its juice can block your stomach and gut from absorbing meds. Taking them at different times may not stop this interaction.

• Constant diarrhea can keep the gut from absorbing meds. Vomiting can too. If you have ongoing diarrhea or are vomiting a lot, talk to your doctor.

MISSING A DOSE
Most people skip a dose of their meds from time to time. This shouldn’t be a problem if it only happens once every month or two. If you’re missing 2 or 3 doses each month, losing track of when you take them, or going whole weekends without them, then this is when resistance can start. Ideally, you should take 95% of your meds.

If you take meds once a day this means missing no more than a couple of doses each month and hopefully not all in a row. If you miss your dose and remember it within a few hours, then take that dose and stay on your normal schedule. If you don’t remember you missed one until much closer to your next scheduled dose, then wait and take the next dose. Do not double-dose. Ask your provider for advice on ways to prevent this.

WHEN YOU’RE SICK
It’s very important to keep taking your HIV meds even when you don’t feel well … like when you have a cold or flu or even feel tired or depressed. Even during most medical procedures or surgeries, you will probably still take your HIV meds. In this case, be sure to tell the doctors and nurses what you take.

PILL AND HIV STATUS FATIGUE
You’ve probably heard or read about adherence. But what often isn’t talked about is the mental or emotional “fatigue” that some people can feel from having to take meds every day ... keeping them handy, taking them daily, paying for them, etc. People also just get tired of being HIV-positive. For a lot of people, this fatigue comes from living with a long-term condition.

The first part of dealing with fatigue is noticing that it’s there. For some people it may be easy to re-commit to taking pills. For others, ask for help. Talking to other HIV-positive people about how they’ve dealt with these issues can show you new ways to deal with yours.

In the long run, it’s much safer to work through pill fatigue than to consider taking a break from your meds. Pill fatigue could also be a sign of depression, so if your feelings persist then let your health care provider know.

Copyright 2018, Positive Health Publications, Inc.

This magazine is intended to enhance your relationship with your doctor - not replace it! Medical treatments and products should always be discussed with a licensed physician who has experience treating HIV and AIDS!