Antiretroviral Therapy (ART): What You Need to Know
HIV used to be a fast track to serious illness. Today, antiretroviral therapy (ART) gives most people living with HIV a chance to live long, healthy lives. If you or someone you care about is starting ART, this page explains in plain language how the drugs work, what to expect, and how to make treatment stick.
How ART works and why combinations matter
ART uses several drugs together to stop HIV from copying itself. Fewer copies mean a lower viral load and a chance for your immune system (measured by CD4 count) to recover. Using multiple drug classes at once prevents the virus from becoming resistant. That’s why doctors usually prescribe a combination pill or two drugs plus a third from another class.
Common drug classes you’ll hear about: NRTIs (like tenofovir, emtricitabine), NNRTIs (like efavirenz), protease inhibitors (PIs), and integrase strand transfer inhibitors (INSTIs, like dolutegravir). Each works at a different step of the virus’s life cycle.
What to expect: side effects, monitoring, and resistance
Side effects vary by drug. Some people get nausea, headaches, or sleep changes for a few weeks. Others may have longer-term issues like weight changes or effects on cholesterol and kidneys. Most side effects are manageable—your provider can switch drugs if needed.
Regular lab checks are part of ART. Viral load tests tell whether treatment is working; the goal is an undetectable viral load. CD4 counts show immune recovery. If the virus becomes detectable again, tests can reveal resistance and guide a new regimen.
Missed doses raise the risk of resistance. Small slips happen, but consistent daily use is the best defense. Use simple tools: phone alarms, pillboxes, or pairing meds with a daily habit like brushing teeth. If you struggle with adherence, talk to your care team—there are support programs and long-acting options now for some people.
Drug interactions matter. Some over-the-counter meds, antacids, and herbal supplements (St. John’s wort, for example) can change ART levels. Tell your pharmacist and doctor about everything you take—prescription, OTC, and supplements—so they can avoid unsafe combos.
Access and cost can be hurdles, but there are options: generics, patient assistance programs, community clinics, and public health services. Don’t skip treatment because of cost—ask your clinic about help.
If you’ve been diagnosed or think you might be, ask for baseline labs, a clear explanation of your regimen, and a plan for follow-up. Good communication with your provider, checking viral load regularly, and sticking to the plan will get you the best results. Want more detail on specific drugs or side effects? Search the site for individual medication guides or contact your local clinic for immediate support.
