Antiretroviral therapy (ART): what you need to know

Modern antiretroviral therapy (ART) can suppress HIV to undetectable levels and stop transmission. That’s not just hopeful—it's real. If you or someone you care about is starting ART, this page gives clear, practical steps: what the drugs do, common side effects, why sticking to the plan matters, and how to get the medicine safely.

How ART works and the main drug groups

ART combines drugs that block HIV at different stages of its life cycle. The common classes are: nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), integrase strand transfer inhibitors (INSTIs), and protease inhibitors (PIs). Most people take two NRTIs plus one drug from another class. Single-tablet regimens exist too — they make taking medication easier and help you stay on track.

What matters most is viral load testing. Your doctor checks the viral load to see if ART is working. If the viral load drops to ‘undetectable,’ the virus can’t be transmitted sexually (U=U). That’s a powerful outcome and the main goal of treatment.

Side effects, resistance, and sticking with treatment

Side effects vary. Short-term issues include nausea, headache, or sleep changes. Some drugs can affect kidneys, liver, or bone density—so expect blood tests and occasional scans. If a side effect is bothering you, talk to your clinician; switching drugs often fixes the problem without losing control of the virus.

Missing doses matters. Skipping meds can let the virus multiply and develop resistance to the drugs you use. Resistance narrows your future options and may require stronger or more complex regimens. Set reminders, use pillboxes, link doses to daily routines, or ask for once-daily options to make adherence easier.

Drug interactions are real. Many antiretrovirals interact with common meds: acid-reducing drugs, some antibiotics, certain heart medicines, and even herbal supplements like St. John’s wort. Always tell every provider and your pharmacist that you’re on ART before they prescribe anything new.

Pregnancy and ART: Effective ART is recommended during pregnancy to protect both parent and baby. Some regimens are preferred for pregnancy—your clinic will guide the safest choices and monitor closely.

Access and safe buying: Get ART through clinics, local pharmacies, or trusted mail-order pharmacies tied to your healthcare. Be cautious with unfamiliar online sellers—look for verified pharmacy credentials and a required prescription. If cost is a barrier, patient assistance programs, insurance prior authorizations, and community clinics can help.

Final practical tip: keep a current medication list, carry a small pill organizer for travel, and bring questions to each clinic visit. Good communication with your care team is the fastest route to steady viral control and a healthier life on ART.