Is Waiting on HIV Meds Ok?

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There are a lot of considerations that go into a decision to start medications for HIV. It is true that the earlier that a person starts medications, the better the long-term outcomes. I am a realist however and I understand that not everyone is ready, willing or able to start medications as soon as they are diagnosed.  Inevitably I come into contact everyday with newly diagnosed individuals who are considering this very question. Here are five points that I would like people to consider when talking about HIV medications.

• Not everyone is ready to commit to medications.
  This doesn’t make a person bad, it simply means that they are not ready to commit. Most people are forced to consider this question only days after being told that they have HIV. I am here to tell you that it takes time to wrap your head around that news. Many times the interested of public health are considered over the well-being of a newly diagnosed person.
• If you are actively using drugs such as heroin, meth or crack… I would suggest not starting medications. 
  This can be counter-intuitive to what we might think. I advise people routinely who are actively using drugs to hold off on starting medications. Adherence and compliance is what we are considering when a person is actively using. When a person isn’t adherent to their HIV medications there is a higher probability that the virus will mutate and the person could become resistant to medications. Additionally there is substantial scientific evidence that shows that the medications lose their efficacy during periods of drug use.
• Do your own research on the medications and choose for yourself.
  This is your health; the most important person that needs to be the most involved is you. This can be a challenge for some since this actually means that you need to be engaged in your own healthcare. Ask questions; if you do not understand something have the medical staff explain it to you. I get questions from people around the world inquiring about labs tests, results and so forth. While I have no problem explaining these things this is why it is so important to have confidence in your healthcare provider.

There is no shame in not being on medications.
There is this tendency to shame people to start HIV medications. This feeds into society’s concept of us versus them. We successfully have created an under-class of people, those who are undetectable versus those people who are not medicated. The fact is that it is your health and you have the right to choose whether to be medicated or not.

Do not feel pressured to account to people as to whether you are on medications or not. Honestly, it is nobody’s busy whether you are medicated or not. When people ask questions, and they will… simply tell them that is personal and you would rather not discussing it.

Be honest with yourself as to why you want to or do not want to start medications.
You need to know that it is your choice to start these medications. That being said, do not make excuses to yourself as to why you are not starting them. Here are some things that I hear all the time- “The side effects are horrible and the meds are worse that the disease itself.” That is simply not true. Here is another one that I hear quite often, “I can’t afford the medications.” There are programs that will cover the medications so for most people this is not a valid argument. If you simply are scared to start the medications, that is ok. It is however important that we be honest with ourselves.

I do not take medications out of a sense of obligation to society. I do not take medications in order to reduce the transmission of the virus. That is a latent effect but ultimately I chose to take medications for myself.

If you are newly diagnosed or maybe a person who has been living with HIV for a period of time, I would say, “Take a breath!” Do your research and give yourself a break. It is ok to freak out and to be scared. There are still moments where I have extreme fear and get scared. Those moments tend to go as quickly as they come.  Whatever you decide remember that this is your body and your healthcare. Hold your head up high and live unapologetically.

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