April 13, 2015

April 13, 2015
10 Questions to Ask Yourself
Before You Begin HIV Treatment

Welcome to another day in my life. Today is Monday and I hope you had a beary safe and great weekend. Dab the AIDS Bear and I are busy with work while my partner is off for a week with the Army Reserve.

After being diagnosed as HIV positive, one of the first things a person has to deal with is finding out if and when they need to start treatment so I thought I would blog on that issue today and tomorrow.

An HIV diagnosis comes with its very own set of questions to ask yourself and decisions to make. Among the biggest is: When should you start treatment? It's a Russian nesting doll of a decision, with many other questions tucked inside.

Here, in no particular order, are 10 of the most important questions to ask yourself before you begin taking HIV medications.

1. Why do I want to start treatment? This extremely important question is not to be confused with, "Why does my doctor say I should start treatment?" It's a way of asking yourself what you want to get out of treatment, and it gets straight at whether you believe that antiretrovirals are necessary to manage your HIV infection.

Starting and staying on HIV treatment is a supreme act of self-respect. This question can unmask any lurking reluctance you may have to take care of yourself. It helps clarify what your main motivation will be to take your HIV medications day after day.

2. Am I ready? The list of reasons for starting treatment earlier than later only gets longer as the supporting data keeps rolling in. But that doesn't mean it's obvious when you should start. The biggest variable in sustained treatment success is you: the person who will have to take meds the right way, every day, indefinitely.

Today's first-line treatment regimens are quite good, but they still require excellent adherence (not missing doses) to avoid the development of drug resistance. The number of possible antiretroviral combinations is finite, and they don't really get easier or better. In fact, the regimen you start with may well be the easiest, most potent regimen available to you -- the kind of thing it would be a shame to lose by taking it when you're not ready.

3. Which regimen will still let me live my life? The greatest combination of medications the world has to offer isn't worth much unless it makes it down your gullet as prescribed, every day. It can be hard enough to start taking daily medications, let alone have to make radical changes to your daily routine for them.

Before you say yes to a twice-daily regimen that requires food, even though you chronically skip breakfast and eat dinner whenever you can grab it, talk to your doctor about other options -- or at least be realistic about whether you can commit to changing your routine. The point of going on treatment is, after all, to stay healthy so you can get on with life without HIV bothering you.

Choosing a regimen that becomes the focus of your life is the wrong direction. It probably isn't realistic and it surely isn't necessary. Be honest about what you are willing (and not willing) to do, choose a regimen that lines up with that, and then take your meds as close to perfectly as you can.

4. Have I surrendered to the truth that I have HIV/AIDS? Denial and shame aren't good for your health, and they can really interfere with your ability to commit to treatment. Some people start treatment because they're "supposed to" or because their doctors think they should, not because they choose to do it as an act of self-preservation. They do it grudgingly, like a chore you do because someone asked you nicely to do but you really can't wait to finish -- and, honestly, you never got why it was important to do, anyway.

Let's face it: Going on treatment means acknowledging, every day, "I have HIV/AIDS." What happens on the days you don't much want to acknowledge that -- to yourself or to others around you? A treatment regimen is dangerous place to play out resentments.

5. Who will I tell about my regimen? Never underestimate the power of support: Hearing a friendly "Have you taken your meds today?" can go a long way toward keeping you on the right path. Sure, it might get old, but it's nice to have someone else paying attention, especially on those days you might not be.

It also can be surprisingly nice to have someone to talk to about your medications. Plus, you'll likely be glad to have an extra pair of eyes and ears in treatment discussions with your doctor -- or even just noticing how you're doing.

Tomorrow I will conclude with the other five questions to ask yourself before starting treatment. Hope you have a beary safe and great Monday!

Until we meet again; here's wishing you health, hope, happiness and just enough.

big bear hug,

Daddy Dab