Does everyone need ART?

Generally yes.

Without ART, HIV will be damaging your health. This is even if you have a high CD4 count.

Not being on treatment steadily increases your risk of serious complications. This is because HIV cause excess immune inflammation.

ART is much easier than people think. It often involves just one or two pills a day. Injectable ART is also sometimes possible.

Although everyone worries about side effects before starting, these are usually mild and you clinic will monitor you carefully.

It is important to be adherent though. Not taking meds can lead to drug resistance. So you need to be committed to taking the meds before you start.

Most people find being on ART is much easier that they thought.

My first reaction was to put off starting therapy. And for as long as possible. I tried to improve my immune system by stopping smoking and using supplements. Then I realised that my best bet was to use ARVs. They are the only way to ensure my long-term survival.

After 8 months of resisting treatment I eventually started ARVs. I do not say that I gave in, but that I became more clever!

— Vladimir, St Petersburg

Last updated: 1 October 2026.