Taking antiretroviral therapy is a long-term commitment. At present, once you start the drugs, you are likely to be on them for the rest of your life. 

For the treatment to work, it is really important that you take the drugs as prescribed. Being involved in decisions about when to start treatment and about which drugs to choose can make it easier to take medication.

Being honest about your lifestyle with yourself and with your doctor can help ensure that you start on a drug combination that is right for you.

Discuss your daily routine with your doctor, adherence nurse or pharmacist to help establish the best times to take your anti-HIV drugs and to identify any concerns before you begin. The chances are that there will be a combination of anti-HIV drugs available that will mean you don’t have to change your lifestyle at all, or make only small changes to your routine.

Treatment guidelines change as new drugs become available, so it is important to keep talking to your doctor about your experience of treatment and your options, to make sure you are taking the right treatment combination for you.

If you miss doses, or you do not take the drugs as prescribed, the HIV in your body is more likely to develop resistance to therapy, and sometimes to other similar antiretroviral drugs that work in the same way. Resistance means the drugs can stop working. Developing a routine will help with taking medication, as can using other reminders such as the alarm on your mobile phone, an app on a smartphone or a pill box.

For more information on preparing to start treatment, and tips on taking your treatment as prescribed (often referred to as ‘adherence’), you may find the Taking your HIV treatment booklet in this series helpful.

Like all medications, anti-HIV drugs can cause side-effects. Quite often, these happen during the first few days or weeks of treatment, but then decrease or stop altogether. Your clinic doctor or GP may also prescribe a number of drugs to help you cope during this initial period.

Side-effects most commonly reported include headache, nausea (feeling sick), diarrhoea and tiredness. You don’t have to try to live with side-effects – if they persist after the early period of therapy tell your doctor, especially if they are interfering with the quality of your life. If you feel you can’t tolerate these side-effects, there are many treatment options available and one of these may suit you better.

Certain side-effects, such as rash and fever, should be reported to your doctor as soon as they happen (see entries on individual drugs for information on potentially dangerous side-effects requiring quick action).

If you are ever worried about a serious side-effect you are experiencing, such as feeling unwell with a skin rash, and your clinic is closed (at the weekend or on a bank holiday), you can attend your nearest Accident and Emergency department.

In this booklet, we generally divide side-effects into two types:

• Common – a side-effect that occurs in at least one in a hundred people (more than 1%) who take this drug.
• Rare – a side-effect that occurs in fewer than one in a hundred people (less than 1%) who take this drug. We have included rare side-effects if they are potentially dangerous and life-threatening.

You can find out more about side-effects and how to deal with them in NAM’s booklet Side-effects.

It is really important that your doctor and pharmacist know about all other medicines and drugs that you are taking – this includes those prescribed by another doctor, over-the-counter drugs, herbal and alternative treatments, medical appliances such as inhalers, nasal sprays, creams, eye drops and injections, and recreational drugs (especially GHB/GBL, ketamine, mephedrone, benzodiazepines and MDMA). Use of poppers along with erectile dysfunction drugs may cause a hazardous fall in blood pressure, especially if you are taking the boosting agents ritonavir or cobicistat as part of your treatment.

Some drug combinations should definitely not be taken together. Reasons for this include serious side-effects, or interactions which can make one or both drugs ineffective or toxic.

Other interactions are less dangerous, but still need to be taken seriously. Levels of one or both drugs in your blood may be affected and you may need to change the doses you take.

You can find out more about drug interactions in NAM’s booklet Taking your HIV treatment and on the website www.hiv-druginteractions.org 

Antiretroviral drugs need to be taken during pregnancy in order to prevent the transmission of HIV from a mother to her baby. It is important to tell your doctor if you are pregnant or thinking about having a baby. You can find out more about HIV and pregnancy in NAM's factsheet HIV and having a baby.

Some forms of hormonal contraception, including patches and implants, as well as oral (‘the pill’), are less effective in women taking many of the antiretroviral drugs, because of drug interactions. Other forms of contraception are unaffected by having HIV or being on HIV treatment and some new drugs do not affect contraception. It is important that you discuss your contraception needs with your clinician, especially if your circumstances change. You can find out more about contraception options from your healthcare team and in NAM's factsheet Contraception.