Fact Sheet Number 416
RIGHT WAY
- HOW DO AIDS DRUGS WORK?
- WHAT IS RESISTANCE?
- KEEPING PRESSURE ON THE VIRUS
- HOW MUCH ADHERENCE IS ENOUGH?
- MAKE IT EASY ON YOURSELF
- THE BOTTOM LINE
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The HIV virus can make millions of copies of itself every day.
Antiviral drugs can’t kill the virus, but they can almost stop
it from multiplying.
A “viral load” test measures the amount of virus
in your blood. If you take anti-HIV drugs, the amount of virus
in your blood should go down. If your viral load is very low,
you probably won’t develop any AIDS-related illnesses. See Fact Sheet 413 for more information
on viral load.
The HIV virus is sloppy when it makes copies of itself. Many
new copies of HIV are slightly different from the original (mutations).
Some mutations can multiply easily even though you are taking
drugs that stop “normal” HIV. This is called “developing
resistance” to the drugs. If your virus develops resistance,
it will multiply faster and your HIV disease will probably get
worse.
Resistance develops quickly if you take just one drug. If
you take three drugs, HIV multiplies much more slowly and it is
much harder for resistance to develop.
Sometimes, when HIV becomes resistant to a drug you are taking,
it will also be resistant to other antiviral drugs – even if you
haven’t used them yet. This is called “cross-resistance”.
Many HIV drugs are at least partly cross-resistant. If your virus
develops resistance to an HIV drug, you might not be able to use
any other drugs of the same type. To avoid using up your treatment
options, take all of your medications according to instructions.
ON THE VIRUS
When you take medications, they get into your blood and are carried
around your body. Then your liver and kidneys start to clean
the drug out of your system, and the amount of medication in your
blood goes down.
Some drugs get into your bloodstream better if there is no
food in your stomach. You take these medications on an empty
stomach. Other drugs get into your bloodstream better if your
stomach is full. You should take these drugs with food. With
some drugs, food doesn’t matter.
The instructions for taking each drug tell you how many pills
to take, when to take them, and how to take them, in order to
keep enough medicine in your blood. If you skip a dose, don’t
take a full dose, or don’t follow the eating instructions, the
drug levels in your blood will drop.
If there is not enough medicine in your blood, HIV can continue
to multiply. The more HIV multiplies, the greater the chance
that resistance will develop.
The best way to keep pressure on HIV is to take all the pills
you’re supposed to, every time you’re supposed to, and follow
the directions about food.
HOW
MUCH ADHERENCE IS ENOUGH?
Adherence means taking your medications correctly. If you don’t,
HIV might multiply out of control. Several research studies have
measured how much adherence is “enough.” They found
that, for the best viral load results, people had to take 90%
to 95% of their pills correctly. If you take pills three times
a day, this means that you don’t miss more than one dose a week.
YOURSELF
It can be difficult to take your medications the way you’re supposed
to. Make it as easy as you can!
- Tell your doctor about your daily schedule so that you can
choose the medications that will be easiest for you to take.
- Make sure you understand your medications:
- Which medications to take
- How many pills to take, and how many times a day
- Whether to take your pills with food, or on an empty stomach
- How to store your pills
- Side effects you might have, and what to do about them
- Plan ahead so you don’t run out of any of your medications.
- Use a pillbox and count your pills out ahead of time. Some
boxes hold enough for a whole week.
- Set a timer or alarm to go off when you have to take pills.
- Choose a regular daily activity to help you remember to take
pills:
- Making your morning coffee
- Getting out of bed
- A favorite TV show
- Coming home from work
- Make sure your family members know how important it is for
you to take your pills. Ask them to help you remember.
You might have problems with side effects, or it might be difficult
to take your pills as prescribed. Don’t cut back or stop taking
your medications until you have talked to your doctor. You
might be able to change your medications and get some that are
easier for you to take.
In order for your medications to work, you need to take them according
to the instructions. If you don’t, your virus might develop resistance
to drugs you are taking. If your virus becomes resistant to one
drug, it might also be resistant to other HIV drugs. For the
best results you have to take over 90% of your pills correctly.
Be sure that you understand which medications your doctor has
prescribed. Make sure you know how many to take, when to take
them, and whether you need to take them with food or when your
stomach is empty.
Work with your health care provider to make it as easy as possible
to take your medications. Use whatever you need to keep on your
medication program: pillboxes, timers, friends, or support groups.
Be sure to talk with your doctor before you make any changes
in your medications or how you take them.
Revised August 23, 2001
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New Mexico AIDS Education and Training Center
and the New Mexico Department of Health