Getting tested for HIV can be an anxiety-provoking experience for many gay men. Decades of stigma paired with misinformation and antiquated knowledge of how HIV is treated can lead to fear, uncertainty, and grief for those who hear the words, “You are HIV positive.”
It can also be overwhelming, so let’s start with some basics.
Did you know that there are medications that effectively treat Human Immunodeficiency Virus (HIV)?
What does “effectively treat” mean and how is this different than a cure? There are a multitude of HIV meds, also known as anti-retrovirals or ARVs. ARVs treat HIV by inhibiting, or blocking, different types of enzymes the HIV virus uses to replicate itself, thereby suppressing replication of the virus.
ARVs only prevent the HIV-infected cells from replicating; however, there are reservoirs of latent, or inactive, HIV-infected cells that are not replicating the virus. “Because the HIV-infected cells in a latent reservoir aren’t producing new copies of the virus, HIV medicines have no effect on them.”
What does it mean to be “undetectable?”
Being undetectable means that a person’s blood has so few copies of the virus that a test is unable to detect it. This does not mean that a person is “cured” from HIV; it means that the HIV meds are working well enough to suppress the virus’ ability to replicate.
Being undetectable means that one cannot transmit the HIV virus to others. We can now say that Undetectable = Un-transmittable.
The recommendation is to start on medications as soon as you find out you have HIV. It is important to get your viral load to undetectable as soon as possible. HIV medications are safer, more effective, and better tolerated than ever before, so there’s no reason to wait to start treatment.
What is a T-cell count or CD4 count?
CD4 T-cells are types of lymphocytes (white blood cells) that are important for the body’s immune system. The HIV virus specifically targets these CD4 cells, which, overtime, reduces the immune system’s ability to effectively fight off infection. Two of the most important lab values your medical provider will check if your are HIV positive are CD4 count and your HIV viral load. The goal is for the viral load to be suppressed (under 20 copies) and for the CD4 count to be at a good, healthy level (500 or above).
What is the difference between HIV and AIDS?
HIV is the virus. AIDS is a condition caused by HIV. One can have HIV but not be diagnosed with AIDS, whereas anyone who is determined to have AIDS also has HIV.
AIDS, or Acquired Immunodeficiency Syndrome, is when a person with HIV has a CD4 count 200 or below, OR, when a person has HIV and an opportunistic infection like PCP pneumonia, tuberculosis, or Kaposi’s sarcoma.
Diagnosed with HIV, now what?
Well, the first step will be to check your HIV viral load and CD4 count by blood testing. A genotype test will also be performed to see if you have any resistance and to help determine what medications would work best.
Usually, you can be started on an HIV medication the day of or shortly after being diagnosed. For many patients, this means taking one single tablet each day. It will be important to take the medication every day without missing and equally important to follow-up with your medical provider on a routine basis to make sure the medications are working well.
I always tell my patients “You have one job and that is to take your medication.” I stress the importance of living an otherwise healthy life: eating healthy, not smoking, exercising, cutting back on alcohol intake, etc. “Studies show that a person living with HIV has a similar life expectancy to an HIV-negative person – providing they are diagnosed in good time, have good access to medical care, and are able to adhere to their HIV treatment.”
If you have tested positive for HIV, set up an appointment with our office so we can go over your treatment plan. If you need to be tested for HIV, give us a call so we can set up a time for you to come in.
We look forward to working with you and guiding you through process.
Jeremiah Robinson is a licensed and certified Physician Assistant at T. Douglas Gurley MD in Atlanta, GA.