page 1 What You Need to Know About Antiretroviral (ARV) Medicines and HIV Infection What are antiretroviral medicines?

What does an HIV positive person's immune system start to fight?
What is the best way to make ARV medicines stronger?
What do you need to give to your children when they are taking antiretroviral medicines?

Transcription

1 2 What You Need to Know About Antiretroviral (ARV) Medicines and HIV Infection What are antiretroviral medicines? These are medicines which can be taken to fight HIV in a person s body. ARV medicines work to keep the level of HIV low in the bodies of HIV positive persons and help keep their 'immune systems' stronger and able to fight disease. Your 'immune system' is the body's defense against disease, and protects you from getting sick. If you are taking antiretroviral medicines, then you are on 'antiretroviral therapy' (ART). Once an HIV positive person begins to take antiretroviral medicines, his or her immune system will begin to slowly get stronger and be able to fight diseases better. page 1 Why are antiretroviral medicines important? Antiretroviral medicines will allow you to live a healthier and longer life so that you can: Watch your children grow and give them love, support and guidance Finish your education and get the qualifications you want Go on working and improve yourself in your career Get married and enjoy family life Go on doing all the things which you enjoy in your life - as long as they support your health. Because ARV medicines are usually not very cheap, you may also find some organisations in your area that can offer ARV medicines either free or at an affordable cost. You may get more information on where to get ARV medicines by having a discussion with other people who are taking antiretroviral medicines or from HIV support groups in your community. In some countries in southern Africa you can get these ARV medicines for free from the public health sector. In the absence of ARV medicines Antiretroviral medicines will make your body strong enough that getting AIDS will take much longer. Where can I get antiretroviral medicines? You can find out where and how to get ARV medicines from the nearest health centre (hospital or clinic) to you, a pharmacist or a doctor that you are able to go to. Antiretroviral medicines do NOT Cure HIV

2 page 2 When will I know it is time that I start taking antiretroviral medicines? There are many things which must be considered and thought about before you begin taking ARV medicines. It is usually not necessary for you to begin taking ARV medicines in the first few years after you become infected. You can stay healthy and strong by using other methods such as: Eating well Exercise Practicing safer sex Coping with your stress Avoiding smoking and alcohol Making sure you attend to any health problems as soon as possible, and other positive living practices. When you want to begin taking antiretroviral therapy you should discuss this possibility at your nearest health centre. Some tests will be done on your blood and a thorough examination of your body will also be done. The decision to begin taking ARV medicines should be a result of a discussion between you and your doctor or health worker. Sometimes doctors have other means of knowing that you need ARV medicines without laboratory tests. How do ARV medicines Work? ARV medicines will slow the process of HIV attacking your immune system and make it less able to weaken your immune system and cause illness. Once you begin treatment, your immune system will begin to gradually recover, get stronger and your ability to fight diseases will improve. Before you begin taking ARV medicines you must: Discuss this with your doctor or other health workers at your nearest health centre. During this discussion consider your social situation, your work and other important things in your life. Get some tests done on your blood to find out if HIV has increased to levels which need you to take medicine to fight it and prevent you from getting very sick. Be willing and prepared to take the medicines every day for the rest of your life. Understand how the ARV medicines work on your body, how to take them and what possible bad effects they may have on your body. Think about their cost, if you have to pay for them. What about the medicines? Antiretroviral medicines are usually combined. This means that if you are on ART you will need to take more than one type of medicine, each time you take your ARV medicines. Combining ARV medicines will make them stronger to fight the HIV in your body. The different ARV medicines which you shall be placed on are called your drug combination. The doctor who gives you the ARV medicines will know what combination is best for you. The best combination is called 'triple therapy'. Triple therapy is when you take three different types of ARV medicines for your treatment. Using only one or two medicines is not a good idea. This is because HIV will get resistant to these medicines more quickly and it will become more difficult to fight it in the future. What is first line treatment? First line treatment refers to the ARV medicines you are put on when you first begin taking them. Some drug combinations used in first line treatment 1 are: Nevirapine Lamivudine Stavudine or Zidovudine Lamivudine Nevirapine What is second line treatment? If you begin getting serious side-effects or develop drug resistance from these first ARV medicines, then your doctor will consider changing your medicines. Before changing 1 Scaling up antiretroviral therapy in resource-limited settings: Treatment Guidelines for A Public Health Approach World Health Organization, Geneva

3 page 3 your medicines, the doctor or health worker will discuss this with you. If you do change your ARV medicines, this new combination of medicines is called second line treatment. Changing your medicines does not mean that you have stopped taking ARV medicines or are cured of HIV or AIDS. Once your doctor has given you your ARV medicines and explained how and when to take them - you must stick to these times and take the correct amount of medicine. What are some common side-effects of ARV medicines? All medicines can have unpleasant effects on your body, even if you have taken them correctly. These effects are called 'side-effects' and some last longer than others. Not everyone who is on antiretroviral medicines gets side-effects. Common side-effects include: Nausea (feeling like vomiting) Headaches Skin rashes Feeling of tiredness Changes in skin colour and nail colour It is very important not to stop taking any of your medicines, without discussing with your doctor or health worker. What happens if I begin getting serious side-effects from the ARV medicines I am taking? It is very important that you let your doctor or a health worker know about your side-effects, especially if they are getting worse. Do not wait untill they get very serious and you become very sick. It may also be helpful to tell a relative or friend who knows you are on these medicines, about these side-effects. They may assist you to get to a doctor or health centre for help. You should report your side-effects as soon as they happen and when they get worse so that your doctor may need to change one or some of the medicines you are taking. Your side-effects could be because of the medicine not working well with your body. Your doctor or the health worker attending to you will know which medicine is giving you problems and may ask you to stop taking that medicine, and give you other ARV medicines to replace them. CD4 count is the blood test which can tell us how strong the immune system (the ability of the body to fight germs and protect it from getting sick) of a person is. CD4 cells are part of the immune system and are very important in keeping our bodies strong and healthy and fighting disease. HIV kills CD4 cells very fast. That is why an HIV positive person can get ill much more easily, can get many different illnesses and not get better quickly. As the years go by HIV kills more and more CD4 cells till the person develops AIDS. Antiretroviral medicines help stop HIV from killing CD4 cells and slow the process of reaching the stage of AIDS.

4 page 4 THE BLOOD TESTS Blood tests are laboratory tests done on your blood before you begin ARV medicines, during the time you are taking them and before you change your drug combination. They include: CD4 counts Viral load Liver function tests to show whether the ARV medicines are working well or whether they are damaging the liver and perhaps need to be changed. The results from these tests will tell us when : Someone must begin taking antiretroviral medicines A person who is taking ARV medicines is reacting well, or not, to the ARV medicines The immune system is getting stronger in someone who is taking ARV medicines. How do I know if I have developed drug-resistance? Drug-resistance happens when the ARV medicines you are taking are no longer fighting HIV in your body, in the way that they should. It can happen if: You do not take your medicines everyday, at the right times and the right amounts the way the doctor or health worker taught you. You practice unsafe sex and become infected with a strain (type) of HIV which can not be easily attacked by some ARV medicines. If you develop drug-resistance then it may become difficult to find ARV drug combinations which will work well to attack HIV in your body. To avoid getting drug-resistance you must: Take your medicines at the correct times and correct amounts and if you forget to do this let a health worker know as soon as possible. Always use a condom when having sex, or practice other safer sex methods. Pregnant women can also take antiretroviral medicines to help prevent their babies from getting HIV before delivery and during delivery. They are usually given: Zidovudine Lamivudine Nevirapine Remember that these medicines are used for a short period to help prevent HIV infection of the baby, they DO NOT treat the mother for HIV. The mother must be put on ART after delivery to treat her HIV.

5 Adherence page 5 Monica is a cross- border trader who operates from Beit Bridge, Zimbabwe I worked as a sex worker here at the border till I fell sick four years ago. I had been into sex work and cross border trading for more than 10 years. I joined the Corridors of Hope programme as a peer educator. It was through the programme that I went for VCT and found out that I was HIV positive. The same programme helped me start on ARV medicines. I am now okay and back to my normal life. I eat healthy and try not to skip meals. Before starting on ARV medicines, I never had regular meals. I would travel on long distance trucks for hours with no food and at times ended up drinking beer before eating any decent food. I have also taken TB medicines and that taught me that I must always eat proper meals. One day I came to trade at the border. I was hoping that I would go back to my house for lunch and take medicines. I met with a regular client that I had not seen for a long time. He was driving to South Africa from Malawi. He insisted that I join him across the border yet he was in a hurry and could not let me go back to my house to take my medicines. I went with him. He bought me some toiletries and clothes to change into on the way. Before sunset, I had already missed 2 doses. I knew I was inviting trouble. I could not ask him for medicines because I did not want him to know that I was taking ARV medicines. I then decided to drink a lot of beer so that I would not keep worrying about the medicines that I had missed. I asked him to pay me a lot of money because I knew that I needed to go straight to the doctor upon arrival in Beit Bridge. I did exactly that. From that day on, I always move with my medicines even when I know that I will go back home. I make sure that I put my medicines at the same place where I put my passport and ID. I know that I never go anywhere without those items. Otherwise my life has changed for the better because I now always make sure that I eat decent food all the time. I now make sure that I eat something before drinking. I have never had problems with my periods or sex desire. Even after I started taking ARV medicines, I have not experienced problems related to my periods. I still go on the unplanned trips with some of my regular clients but there are crucial items that I always carry with me and now my ARV medicines have become part of the important items that I am always with. I also move with female and male condoms and insist on the use of either of these. PLEASE REMEMBER - Even if you are getting stronger when taking antiretroviral medicines - HIV is still in your body and you can pass it on to others. - Even if you are getting stronger with ART, HIV is still present in your body and you can pass it on to others. - Only the doctor or health worker can change your medicine. - You must begin taking ARV medicines if: Your CD4 count is less than 200 You are getting very sick very often and not getting better even when taking medicines for the illnesses.