HIV Treatment/Management

By Dr Kelvin Adams. Updated 18th May 2016

HIV treatment and management at Northside Clinic.

In the years since the mid 1990s , we have seen an extraordinary improvement in the prognosis and prospects for people living with HIV and AIDS.  The variety of antiretroviral medications available have led to HIV infection becoming a manageable and treatable condition in contrast to the appalling prognosis that existed for patients 25 years ago.

In Australia HIV treatments are available in Hospitals , Sexual Health Centres and in a number of General Practices with a special interest in the area. Many people living with HIV find accessing treatment at a special interest General Practice more convenient than through hospitals. General Practice can offer a choice of appointment times and the ability to address issues other than just HIV.

Northside Clinic has been involved in HIV management since the beginning of the epidemic and many of the doctors at Northside Clinic have the experience and qualifications to treat people living with HIV and to prescribe the appropriate medications. We maintain close links with all the other HIV services in Melbourne and, when necessary, we can help patients in cooperation with appropriate hospital specialists.

Current Australian HIV treatment guidelines recommend commencement of Anti Retroviral Therapy (ART) in all HIV positive people, regardless of CD4 count, at or as close as possible to the time of diagnosis with HIV.  The basis for this is to improve the person’s health, prolong their life, and reduce the risk if transmitting HIV to others.

All decisions to start ART should be made by the individual with HIV, in consultation with their Doctor. There are many factors to consider such as:

-Your readiness and willingness to take medication

-The need for lifelong medication

-The need for high adherence.

 

When starting ART, 3 drugs are usually used.  Often, all 3 drugs are contained in the one tablet, so you may only need to take one tablet once a day (STR or Single Tablet Regimen). However, not everyone is suited to a STR. This decision depends upon any drug resistance that your HIV virus may have, side effects that may not suit you, or other medical conditions that may preclude you.

Currently, once you start ART, treatment is life-long.

At the moment there is strong evidence to show that taking ART if you are HIV positive can prevent transmission to other HIV negative people. This is known as Treatment as Prevention (TasP). Studies have shown that if you are on ART and have undetectable viral load, there is very little risk of transmission to a negative partner, even if you have condomless sex. However, a very low rate of transmission cannot be totally ruled out.

Currently the only way to prevent HIV is to practice safe sex by using condoms and/or taking PrEP, and not sharing injecting drug equipment. It is also a good idea to get regular STI testing.

There is currently no preventable vaccine against HIV.