HIV goes through several stages during its lifespan. The virus begins with its entry into a healthy cell and continues as the cell makes copies of the virus and releases them into the bloodstream. Newly released cells then go on to infect other cells and the process repeats itself billions of times a day.

Medications called antiretrovirals work best against HIV by interfering with the various stages of the virus lifespan. Many factors determine whether you need antiretroviral medication to treat HIV. The goal of medication therapy is to achieve undetectable levels of the virus in your bloodstream and to stay on an effective medication regimen for as long as possible.

There are a number of combinations of antiretroviral medications or regimens. Some regimens require several pills. Other regimens use a fixed-dose combination, which is two or more medications formulated into a single pill, taken once a day. Using fixed-dose combinations minimizes the number of pills taken each day, and as a result, makes it easier for people to be adherent.

The recommended treatment for HIV/AIDS is a combination of three or more medications, which is called Highly Active Antiretroviral Therapy, or HAART. Sometimes called "cocktails," these medication combinations work to reduce the amount of HIV in the body for an extended period of time.

No matter which combination you are prescribed, the most important thing is that you take the medication exactly as prescribed. Missing doses can cause allow the virus to mutate and quickly becomes resistant to medication.

Adhering to therapy

Adherence means taking your medications exactly as prescribed by your healthcare provider. Adherence is important for any medical condition, but it is especially important in HIV infection because of the risk of drug resistance. Missing doses allows drug levels in your blood to drop, which can then allow HIV to replicate, or reproduce itself and begin to resist the medication. This is called "resistant virus." Over time, the levels of resistant virus in the blood increase, causing your medications to become less effective or stop working all together.

It can't be emphasized enough: Do not miss any doses of your medications. If you miss a dose, take it as soon as you remember. In most cases, if it is almost time for your next dose when you remember, you should not take the missed dose or take two doses of the medication at the same time.

• Order your refills a week before you run out.
• Make sure you have enough medication when you travel or during holidays.
• Associate your medication-taking with a daily activity. For example, if you take your medication once a day, take it after brushing your teeth, using the bathroom or inserting your contact lenses.

When you take your medications may vary, depending on your particular medication, your treatment plan or your daily routine. It is important to take them around the same time each day. This is important to keep the levels of the medications in your body high enough to suppress the virus. Very few people need a regimen that is more than twice a day.

Many HIV medications must be stored at specific temperatures to remain effective, which may mean keeping medications at room temperature or in a refrigerator. Check with your pharmacist or refer to the drug information that came with your medication for specific storage directions.

Side effects

If you are having unmanageable or intolerable side effects or other problems with your medication therapy, tell your healthcare provider, but never stop taking your medications unless your healthcare provider tells you to do so.

Controlling nausea and vomiting is important so your medications remain in your body and you are able to take them as prescribed. If your medications are not absorbed by your stomach, they cannot work with your immune system to fight the HIV infection.

If you have nausea and vomiting associated with your medications or HIV infection, you can do several things to make them better.

• Take your medications with food, unless your healthcare provider instructs you otherwise. Food helps minimize the effects of the medications on your stomach and make you less likely to have nausea and vomiting.
• Stay calm and as quiet as possible—sudden movement can make nausea and vomiting worse.
• Take deep breaths in through your nose and exhale slowly through your mouth.
• Make sure you are in a well-ventilated room and avoid strong odors. Consider acupressure to relieve nausea and vomiting.
• Ask your healthcare provider about medications you can take to control nausea and vomiting.

When you begin to eat, start with small amounts of either ginger ale or water. If tolerated, try other easily digested foods such as gelatin (JELL-O® gelatin), clear soups (chicken or beef broth) and weak tea. Once your stomach is more settled, you can resume eating normal food.

Ask your pharmacist or healthcare provider about food restrictions with your medication regimen. Some medications need to be taken with food, others should be taken without food and still others are not affected by food at all. Some medications can interact with certain food products, such as grapefruit and its assorted products.

Complementary or alternative therapies

Talk with your provider or pharmacist before you use complementary or alternative therapies. These medications are neither regulated by the FDA nor may they be always safe. Some substances can interact with your HIV medications, and only your pharmacist or healthcare provider can help you understand what's safe. Most substances have not been studied enough to establish whether they are safe or whether they can help control HIV. This doesn't mean they don't work, but that there is not enough available information.

Research has not found any alternative therapy that is effective at controlling HIV as well as FDA-approved antiretrovirals. Many complementary or alternative therapies are also very expensive.