Guides

What is the best combination?

Person scratching their hea

Although there are many approved HIV drugs, UK guidelines only recommend four main combinations.

These are all based on a second-generation integrase inhibitor: either dolutegravir or bictegravir. All four combinations are all very effective and easy to take.

Four alternative combinations can also be used in certain situations. These are also safe and effective if you need to use them.

The main focus is to choose ART that will be both effective and easy to take.

Ask your doctor about your choices. This will depend on whether you have taken HIV drugs before, or have drug resistance.

Information about dosing, pill size and side effects will help you pick ART that is right for you.

  • There isn’t one best combination. The one that is best for you depends on your medical history and your choice.
  • All modern combinations are very good. They can all reduce your viral load to undetectable levels.
  • This means choosing meds that are easy to take.

Talk to your doctor about your choice of treatment. If you have taken HIV drugs before, or have drug resistance, this will affect your choice.

Ask about:

  1. Dosing – how many pills and how many times a day.
  2. Pill size – some pills are bigger than others.
  3. Food – do they need to be taken with food?
  4. Side effects – side effects might affect your choice, but this is a low risk with all ART.

For example, tell your doctor if taking meds with food will be easy or more difficult for you.

5. If you have difficult with oral pills, some people can switch to injectable ART. This currently involves injections into your buttocks every two months. This combination uses cabotergravir-LA (an INSTI) and rilpivirine-LA (an NNRTI).

Get involved in choosing your treatment. If need to fit to your life, schedules and routines as much.

Being able to share with my relatives and close friends has helped me a lot. My boyfriend always asks me if I took the pills at time.

I’ve been taking HIV treatment for the last 20 years. When I started, no one would had imagined the choice we have now. I now feel truly optimistic about the future.

As new drugs become available, choices will become even more individualised. A good relationship with our doctors and nurses is important: we’ll probably need to see them for years!

— Xavi, Barcelona

Last updated: 1 November 2024.