Medicines for HIV and AIDS
No medicines can cure HIV yet. But people who have
HIV can live much longer, healthier lives by taking
antiretroviral therapy (ART), a combination of several
medicines that must be taken every day. ART
medicines also help prevent the spread of HIV to a
baby during pregnancy and birth. Check with your
local health authority about what ART medicines are
available where you live and how to use them.
For more information about HIV infection, see
pages 99 and 334. Also see page 478 for another medicine, cotrimoxazole, that can
prevent many infections in people with HIV.
Where can a woman get ART? ART medicines are available from HIV or AIDS
treatment programs, from clinics and hospitals, and from programs for prevention
of mother-to-child (or parent-to-child) transmission, called PMTCT or PPTCT
programs. In many places, the medicines are free. A woman taking ART should
have regular health care visits about how the ART is affecting her health.
When do women start ART? The best way to know when to start ART is by having
a CD4 test, a blood test that measures the strength of the immune system. Most
people start ART when their CD4 count is less than 350 (a healthy CD4 count is
over 800). When CD4 tests are not available, ART may be started based on the kinds
of illnesses a woman has. Women with HIV and tuberculosis should start ART 2 to
8 weeks after beginning treatment for tuberculosis, no matter what their CD4 count
is. Women with HIV and hepatitis B should also start ART as soon as possible.
All pregnant women with HIV should take ART, either for their own health or
for a limited period of time to protect the baby from HIV. For best protection of
the baby, a woman should start taking ART medicines as soon as possible after
14 weeks (3 ½ months) of becoming pregnant. See page 495.
Before starting ART:
Which medicines to use or when to start ART may depend on the woman’s
health. A health worker will consider conditions such as pregnancy, severe illness
or long-lasting fever, anemia, tuberculosis, diabetes, heart disease, or hepatitis, as
well as whether she has ever taken ART in the past. Women who live in areas where
there is a lot of tuberculosis should talk to a health worker about taking isoniazid
to prevent TB.
Women who take ART must take it every day, without fail. If a woman stops taking
ART, her HIV will start making her ill again. Taking ART some days and not others
lets HIV become resistant to the medicines. This means that those medicines will no
longer work as well to treat her. A midwife, as well as people who manage ART
programs, can work to ensure there is a steady supply of ART for people with HIV.
Talking to another person using ART can help a woman find ways to deal with
difficult side effects of the medicines. Also, someone within her family who knows
she has HIV can help remind her to take her medicines every day. Keeping HIV a
492 secret can make it difficult to take medicines at the right time.
A Book for Midwives (2010)