Until recently, doctors weren’t sure of the best time to start HIV treatment. However in 2015 a large, well-conducted study demonstrated that there are advantages to starting treatment as soon as possible, with high CD4 cell counts. The study clearly demonstrated that starting HIV treatment earlier reduces the risk of serious illnesses, AIDS and death. While people sometimes worry about the side-effects of anti-HIV drugs, the study also showed that people who began HIV treatment earlier had a better quality of life than people who waited.

Other large studies have shown that taking treatment and having an undetectable viral load dramatically reduces the risk of HIV transmission. 

And other research has shown that with HIV treatment many people living with HIV can have a more or less normal lifespan.

The sooner you start to take HIV treatment, the sooner you can benefit from it.

HIV treatment guidelines, both in the UK and elsewhere in the world, now recommend that all people with HIV should take HIV treatment, regardless of their CD4 count.

If your CD4 cell count is below 200, it is especially important that you begin HIV treatment as soon as possible. The lower your CD4 cell count, the greater the risk of HIV making you ill. But even at higher CD4 cell counts, above 500, treatment you take now will protect your health, both now and in the future.

While the medical case for starting treatment as soon as possible is clear cut, the decision to start treatment rests with the person living with HIV. Before starting treatment, it’s important that you understand how it works and what it involves. You may need a little time before you feel ready to start.

If you have HIV, you should see a doctor regularly for a check-up. How often this is will depend on a number of factors, including whether you are on HIV treatment and how it is working, and your general health.

Most people with HIV attend sexual health clinics or other specialist HIV clinics, which have doctors and other health professionals trained in HIV care. Even if you do not need to start HIV treatment at this stage, regular blood tests will tell you about the health of your immune system and indicate when you should think about starting. Regular discussions with your healthcare team will identify if you have other reasons to consider starting treatment. 

In England, all HIV care and the anti-HIV drugs provided through NHS HIV clinics and sexual health clinics are free (including no prescription charge), whatever someone’s immigration status is. 

In Scotland, Wales and Northern Ireland, people are not normally charged for HIV treatment and care, although the law still says they can be if they are of uncertain immigration status. An HIV support organisation can help you if you are concerned about being charged for treatment. You can look for support organisations in NAM’s online directory, the e-atlas (www.aidsmap.com/e-atlas).