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HIV Care and Treatment Basics

CDC Consumer Resources

Understanding Care – This fact sheet in a frequently asked questions (FAQ) format outlines and explains the different aspects of HIV care. Topics include: the types of health care and social service providers that are part of an HIV care team; how to get the most out of HIV care; what to expect during medical visits; and the tests used to monitor HIV infection. Also available in Spanish.

HIV Treatment – This fact sheet provides an overview of HIV treatment in FAQ format.  Topics include: what antiretroviral therapy (ART) is; when to start ART; the health risks of delaying ART; the benefits of taking ART consistently as prescribed by a medical provider; the potential side effects of ART; options when an ART regimen is not working; and tips for successfully adhering to treatment. Also available in Spanish.

Resources for People with HIV – This resource list describes and links to many different types of resources for services and education, including: finding HIV care and treatment; getting help paying for HIV care; finding housing and job assistance; getting help with legal issues; finding mental health treatment; finding guidance on traveling safely; and learning about HIV stigma and discrimination. Also available in Spanish.


CDC Provider Resources

HIV Treatment and Care – This issue brief focuses on ART, with information on the following topics: initiating ART; ART adherence and viral suppression; barriers to adherence and ways to address them; viral load testing; ongoing HIV care; and coinfections, such as sexually transmitted infections, viral hepatitis, and opportunistic infections.

Talking to Your Patients – This web page describes how providers can communicate effectively with their patients. Topics include: fostering patient trust; helping patients remain connected to HIV care; encouraging open communication and collaborative decision-making; and addressing potential barriers to accessing medical care and support services. This also links to a related issue brief that focuses on safer sexual behavior.  

Retention in Care – This resource examines several topics related to retention in HIV care: factors associated with poor retention in care; barriers patients face to remaining in care; and tips on communicating effectively with patients to help keep them engaged in care.

ART Adherence – This issue brief covers a range of topics on ART adherence, including: talking with patients about adherence; determining if a patient is ready to begin ART; and barriers to adherence and ways to address them.

Prevention for Persons with HIV – This issue brief summarizes studies indicating that successful ART is effective in preventing HIV transmission; discusses how providers can talk with their patients about the value of HIV treatment as prevention; explains pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP); and describes other prevention strategies to halt HIV transmission.


HIV.gov Consumer Fact Sheets

Locate an HIV Care Provider – This explains why it is important for people with HIV to have a provider knowledgeable about HIV care, how to find an HIV care provider, and the importance of connecting with HIV care as soon as possible after diagnosis.

Types of Providers – This discusses the range of providers who may be part of an HIV care team, including medical care providers, allied health professionals, social service providers, and patient navigators.

Take Charge of Your HIV Care – This provides guidance on how people with HIV can work well with their health care team, including making and keeping medical and other health-related appointments, communicating openly with providers, and keeping track of health services received.

What to Expect at Your First HIV Care Visit – This discusses the types of questions HIV health providers may ask, the exams and tests they may perform or order, and the HIV care and treatment strategies they may discuss.  Also addresses the role of CD4 count and viral load testing in monitoring the state of HIV infection.

Making Care Work for You – This explains the benefits of staying in HIV medical care and seeing health providers regularly, and describes steps people can take to get the most from their medical care.

Seeing Your Health Care Provider – This includes guidance on managing HIV medical appointments, preparing for visits, and communicating effectively as an active participant in one’s HIV health care.

HIV Treatment Overview – This provides basic background about what ART is, why ART is important for people with HIV, when to start ART, potential side effects, and what drug resistance is and how to avoid it.

Taking Your HIV Medication Every Day – This explains why it is important to take HIV medicines consistently as prescribed, what to do after missing a dose, and the reasons for continuing ART after reaching an undetectable viral load.

Tips on Taking Your HIV Medication Every Day – This describes the challenges that sometimes lead people to stop taking HIV medications or miss doses, and tips to help people take medications consistently as prescribed.

Paying for HIV Care and Treatment – This provides an overview of the many different options that are available to help people access and pay for the HIV care and treatment they need.

HIV Treatment as Prevention – This explains how ART helps people with HIV stay healthy and prevents transmission of the virus to others. It also explains the importance of maintaining an undetectable viral load, provides guidance on talking with providers and sexual partners about HIV treatment and risk, and describes other prevention benefits of ART.

Pre-Exposure Prophylaxis (PrEP) – This describes what PrEP is and how it can reduce the risk of becoming infected with HIV, the reasons for considering PrEP and who can benefit from it, the drugs approved for PrEP, PrEP safety, how to get PrEP, and how to get help paying for PrEP.

Post-Exposure Prophylaxis (PEP) – This describes PEP and its role in HIV prevention, situations in which PEP is prescribed, as well as the duration, effectiveness, and potential side effects of PEP regimens.

Lab Tests and Results – This explains the range of lab tests that medical providers may use to monitor and manage HIV, as well as tests to screen for or manage other possible health issues, such as infectious diseases, cancer, cardiovascular disease, and diabetes. 

Returning to Care – This describes the reasons why people sometimes leave HIV care, the importance of returning to care, and the types of assistance available to help people reconnect with HIV care. 


HIVinfo Consumer and Provider Fact Sheets on HIV Treatment and Side Effects

FDA-Approved HIV Medicines – This is an annotated table listing all HIV drugs and combination medicines approved by the U.S. Food and Drug Administration (FDA). For each medicine, the table includes the drug class(es); the generic name, alternative names, and acronyms; the brand name; and the FDA approval date.  There are also links to corresponding drug fact sheets in the Clinicalinfo.HIV.gov Drug Database. Also available in Spanish.

HIV Treatment: The Basics – This describes what ART is, how HIV medicines work, when to start ART, the types of medicines included in an HIV regimen, side effects, and drug interactions. Also available in Spanish.

Just Diagnosed: Next Steps After Testing Positive for HIV – This includes information about the first visit to a health care provider to discuss HIV and treatment options, lab tests used to make decisions about HIV treatment, current guidance on when to start ART, common questions newly diagnosed persons ask providers, and other resources for newly diagnosed persons. Also available in Spanish.

When to Start HIV Medicines – This explains current recommendations on when to start ART, conditions for which it is especially important to start ART immediately, and the importance of taking medications consistently as prescribed. Also available in Spanish.

What to Start: Choosing an HIV Regimen – This explains what an HIV regimen is, the different classes of HIV drugs, the factors considered when choosing an HIV regimen, and how long it takes HIV medicines to work. Also available in Spanish.

Drug Resistance – This provides an overview of drug resistance, resistance testing, and steps patients can take to reduce the risk of developing drug resistance. Also available in Spanish.

HIV Treatment Adherence – This describes what adherence is and why it is important. It also provides a list of additional resources about adherence and related issues. Also available in Spanish.

Following an HIV Regimen: Steps to Take Before and After Starting HIV Medicines – This focuses on things patients and their health care providers should discuss that are relevant to HIV treatment, including: all prescription and nonprescription medicines, vitamins, nutritional supplements, and herbal products that a patient is taking; adherence strategies; HIV medication adherence; challenges that might make adherence difficult; adherence strategies, tools, and tips; and what people should do if they miss doses of HIV medicines. Also available in Spanish.

What Is a Drug Interaction? – This describes the different types of drug interactions and how they may affect people taking HIV medicines, as well as tips for avoiding drug interactions. Also available in Spanish.

HIV and Immunizations – This focuses on immunizations, including information about what vaccines are, vaccine safety, efforts to develop HIV vaccines, and immunizations recommended for people with HIV. Also available in Spanish.

HIV Medicines and Side Effects – This describes what side effects are, the types of side effects that are most often seen in people taking HIV medicines, and strategies for managing side effects. Also available in Spanish.

HIV and Diabetes – This explains what diabetes is, describes risk factors for diabetes, and provides information about the symptoms, diagnosis, and treatment of diabetes. Also available in Spanish.

HIV and Hepatotoxicity – This explains what hepatotoxicity is, factors that increase the risk of hepatotoxicity in persons taking HIV medicines, as well as the symptoms, testing, and treatment of hepatotoxicity. Also available in Spanish.

HIV and High Cholesterol – This describes what high cholesterol is and the risk factors, symptoms, prevention, and treatment of high cholesterol levels. Also available in Spanish.

HIV and Lactic Acidosis – This explains what lactic acidosis is, as well as its symptoms and treatment. Since severe cases of lactic acidosis can be life-threatening, this also provides guidance on when to seek immediate medical attention. Also available in Spanish.

HIV and Lipodystrophy – This describes lipodystrophy and its different types, including fat buildup, loss of body fat, and combination fat gain and loss in different parts of the body. Information is also provided on the causes and treatment of lipodystrophy. Also available in Spanish.

HIV and Osteoporosis – This describes what osteoporosis is, as well as its risk factors, causes, symptoms, treatment, and steps people can take to prevent osteoporosis. Also available in Spanish.

HIV and Rash – This explains why people with HIV sometimes develop rashes, and describes the rash-related conditions that require immediate medical attention. Also available in Spanish.


HIVinfo Consumer and Provider Infographics

The National Institutes of Health HIVinfo website has created a series of infographics in English and Spanish focusing on HIV care, treatment, and related issues.  These include:


HHS Guidelines for HIV Care and Treatment

Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV – These guidelines from the U.S. Department of Health and Human Services (HHS) provide detailed recommendations on: baseline evaluation of persons diagnosed with HIV; laboratory testing; treatment goals; starting ART; treatment as prevention; what drugs to start ART with; what not to use; management of treatment-experienced patients; special patient populations; treating patients with coinfections; limitations to ART safety and efficacy; and drug-drug interactions. 

Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection – These guidelines focus on infants, children, and adolescents in early to mid-puberty with HIV. They provide detailed recommendations on: maternal testing and identifying perinatal HIV exposure; HIV diagnosis in infants and children; clinical and laboratory monitoring; when to start treatment; what to start treatment with; management of perinatal HIV exposure; special considerations when using ART in adolescents; ART adherence; managing medication toxicity or intolerance; and managing children receiving ART. 

Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States – These guidelines provide detailed recommendations on: maternal HIV testing and identification of perinatal HIV exposure; the use of PrEP to reduce HIV risk during the periconception, antepartum, and postpartum periods; preconception counseling and care; antepartum and intrapartum care and postpartum follow-up; providing counseling and care to women with HIV who breastfeed; and providing care to infants born of women with HIV. 


HIV Educational Curriculum

The second edition of the National HIV Curriculum was completed in 2020 by the AIDS Education and Training Center, University of Washington, and their partners. The curriculum includes two self-study modules focusing on the care and treatment of persons with HIV.  Module 2: Basic HIV Primary Care summarizes current knowledge on evidence-based primary care to persons with HIV.  It includes the following sections:

  • initial evaluation of persons with HIV infection who are entering, re-entering, or transferring care;
  • oral manifestations;
  • cutaneous manifestations;
  • immunizations in adults;
  • primary care management;
  • screening for mental health conditions;
  • substance use disorders; and
  • retention in HIV care.


Module 3: Antiretroviral Therapy is designed to help providers apply evidence-based strategies in managing ART for persons with HIV. It includes the following sections:

  • antiretroviral medications and initial therapy;
  • adverse effects of antiretroviral medications;
  • drug interactions with antiretroviral medications;
  • switching or simplifying antiretroviral therapy; and
  • evaluation and management of virologic failure


The National Curriculum also has an Antiretroviral Medications section that provides detailed information about approved HIV medications, including single-tablet regimens, long-acting injectable regimens, and medications in particular drug classes. Each medication entry includes a drug summary, a summary of clinical trials featuring the medication, prescribing information, research references, and teaching resources. 

 

Selected Resources from AIDS Education and Training Centers (AETCs)

HIV Care Continuum: Key Resources for HIV Clinicians (AETC National Coordinating Resource Center and National Clinician Consultation Center, December 2022) – This is compilation of key resources for each stage of the HIV care continuum, including HIV testing and diagnosis, linkage to care, retention in care, ART, and viral suppression.

HIV Primary Care Update (New England AETC, September 2022) – This webinar covers important emerging areas of HIV medicine including primary care screening, behavioral prevention, PrEP, ART, the HIV care continuum, cultural competence, and stigma and discrimination.

IAS 2022 Conference Highlights (Mountain West AETC, September 2022) – These training slides review updated HIV prevention and treatment recommendations based on research findings from the 2022 International AIDS Conference.

IAS Update 2022 (New England AETC, August 2022) – This webinar summarizes significant findings and key updates from the 2022 International AIDS Conference. Topics include: behavioral prevention, PrEP, ART, the HIV care continuum, and viral hepatitis.

Rapid (Immediate) ART Initiation & Restart: Guide for Clinicians (AETC National Coordinating Resource Center, May 2022) – This guide summarizes best practices for immediate ART initiation and is based on resources from San Francisco’s Getting to Zero RAPID (Rapid ART Program Initiative for HIV Diagnoses).

Antiretroviral Therapy: Where are We Now? Where are We Going? (Midwest AETC and others, April 2022) – These training slides review new/investigational ART, emphasize the clinical need for new ART options and paradigms, and review how to select newly approved ARTs for certain clinical situations.

Emerging HIV Treatment Options (Northeast/Caribbean AETC and others, April 2022) – These training slides provide an overview of the role of cabotegravir/rilpivirine injectables and other novel formulations in development for HIV treatment and prevention, and review shifting treatment paradigms – two versus three drugs for HIV treatment.

Long-Acting Injectable HIV Treatment and PrEP (New England AETC, March 2022) – This webinar provides information about new long-acting HIV injectable cabotegravir for PrEP and cabotegravir/rilpivirine for treatment.

New and Investigational ART Drugs and Strategies (New England AETC, March 2022) – This seminar focuses on new developments in antiretroviral therapy, including new strategies for the use of existing drugs, recently approved drugs, and new agents on the horizons.

CROI Update 2022 (New England AETC, March 2022) – This webinar discusses key updates from the 2022 Conference on Retroviruses and Opportunistic Infections (CROI 2022), including news on ART.

CROI 2022 Report Back: Treatment Updates (Mountain West AETC, March 2022) – These training slides focusing on CROI 2022 include news on ART.

ART Timing for Selected Opportunistic Infections (Mountain West AETC, February 2022) – These case-based training slides review appropriate ART initiation timing for TB and cryptococcal meningitis.

HIV Treatment Guidelines and PrEP (New England AETC, January 2022) – This webinar provides updates on CDC/DHSS HIV clinical guidelines on HIV testing; ART, including treatment options when virologic failure occurs; linkage to care; and pre-exposure prophylaxis.

ART Update: New Guidelines & Medications (Mountain West AETC, December 2021) – These case-based training slides review new ART guidelines and medications.

International AIDS Society Update 2021 (New England AETC, October 2021) – This webinar includes important updates from the 2021 IAS Conference, including news about ART.

2021 International AIDS Society Conference Highlights (Mountain West AETC: August 2021) – This presentation slide set covers highlights from the 2021 IAS Conference, including ART.

HIV Treatments: Current and New Modalities (New England AETC, July 2021) – This podcast session covers how different HIV medication classes function to suppress viral replication, and reviews current and newer ART regimens.

CROI Update 2021 (New England AETC, April 2021) – This webinar summarizes of highlights from CROI 2021, including recent developments in HIV treatment and care.

 

The contents listed on this page are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, the New England AIDS Education and Training Center.