Q and A

Question

When should I start treatment?

Answer

Hi

HIV treatment (ART) is now routinely recommended for all HIV positive people.

But exactly when to start is an individual decision.

How quickly you need to start depends on many factors. These include:

  • How long you are likely to have been HIV positive.
  • Your current CD4 count and viral load.
  • Whether you have other infections.
  • Whether you are likely to need special support to take meds.
  • Whether you are pregnant.
  • Treatment guidelines in your country.

As long as there is not a medical urgency (such as pregnancy or a very low CD4), it is okay to take time to decide. If you were recently infected, this might be a reason to start ART more quickly.

You are the person who has to take the meds. You have a choice over when to start and the drugs you use.

Discuss this with your doctor before you need treatment.

  • Ask about the different drugs. You need to know the good and bad things about each of them.
  • Take time to think about what you want to do. Do not feel rushed or pressurised into doing something you don’t understand.
  • If you have just been diagnosed, you may want time to think about this before you feel ready to start treatment. Unless your CD4 count is very low this should usually be ok.

UK guidelines recommend that anybody who is HIV positive can start ART. There are similar recommendations in the US and in WHO guidelines.

A few countries still recommend waiting until the CD4 count is less than 500.

The i-Base Introduction to ART guide has more information about starting treatment.

This answer has been updated many times from an original question in November 2012.

4 comments

  1. Rebecca McDowall

    Hi Robert,
    I’m very sorry to hear about your recent diagnosis. It can be very difficult telling people about this when you are first diagnosed and it’s normal to feel worried about telling your partner about this. It’s fine to take your time and only do this when you feel ready. You might find that it helps to find somebody to talk to about this though, so you have some support. Have you been able to tell anybody about your diagnosis yet?

    HIV treatment should be confidential wherever you live and you should be able to get treatment without your partner finding out. If you are worried about this discuss it with your clinic.

  2. Robert

    Please Ifine out that I’m positive .and I’m scared to tell my partner so how can I get treatment and drugs.

  3. Rebecca McDowall

    Hi Bonny,
    It’s normal to feel worried about telling partners about HIV. It’s up to you to decide if and when you want to do this. This page, from THT, has advice and information about talking to partners about HIV. Have a look there and let me know if you have any questions or would like any further info.

  4. Bonny

    Hi I’ve recently found out I’m HIV positive I’m 24 and scared to tell my partner as we’ve just started dating.

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