HIV drugs keep the virus from multiplying in the body, which benefits the person with HIV and prevents transmission of the virus to others.
Research has firmly established that people with HIV who achieve and maintain an undetectable viral load—the amount of HIV in the blood—by taking HIV treatment as prescribed cannot transmit the virus during sex. An undetectable viral load also reduces the risk of HIV transmission during pregnancy, labor, and delivery to 1% or less, according to the Centers for Disease Control and Prevention. It also substantially decreases, but does not eliminate, the risk of HIV transmission through breastfeeding.
People with HIV sometimes get other illnesses and complications related to HIV, even when the virus is well-controlled with treatment. These include co-infections like hepatitis C and tuberculosis, as well as non-infectious complications such as heart disease. People with advanced-stage HIV may develop serious opportunistic infections, like pneumocystis pneumonia or cryptococcal disease. There are treatments available for many of these other illnesses.
The National Institute of Allergy and Infectious Diseases has more information about HIV treatment research.
For the most part, HIV treatments for women are the same as for men. However, there are some special considerations related to treatment of HIV for women, including:
- Birth control. Some anti-HIV drugs interact with hormonal birth control. This may mean that a woman taking certain HIV medications is more likely to become pregnant even if she's using contraception. Women with HIV who want to avoid pregnancy should talk to their healthcare providers about the safest and most effective birth control method for them.
- HIV medication during pregnancy. All pregnant people with HIV should receive HIV medications to benefit their health and prevent transmission of the virus during pregnancy and childbirth.1
- Perinatal transmission. During pregnancy, birth, and nursing, HIV can pass from a mother to her child. Pregnant people with HIV can prevent this if they take their anti-HIV drugs as prescribed and give HIV medicine to their babies in the weeks after birth. Avoiding breastfeeding when formula feeding is available also is recommended. Read more about preventing perinatal transmission of HIV.
Because of their developing bodies, children and teens have to take different amounts, formulations, and combinations of anti-HIV drugs than adults.
Children and youth might also require special treatments for side effects of HIV or anti-HIV drugs. For example, the widely used anti-HIV drug tenofovir can make youths' bones weaker and could endanger their long-term bone health. NICHD-sponsored research found that vitamin D pills may prevent this problem.
The best treatment strategy may be different for each child or teen. These are some factors that affect treatment decisions:
- Availability of pediatric anti-HIV drug formulations. Young infants cannot swallow pills or capsules and, therefore, require special drug formulations, such as liquids. Not all anti-HIV drugs available for adults have formulations that infants and young children can take.
- Availability of pediatric dosing information. The doses of anti-HIV drugs that need to be given are different in children than adults, and also vary in children of different ages. Not all anti-HIV drugs approved for adults have been studied in children to determine the right dose for children. Additionally, dosing information for some anti-HIV drugs may be available for older but not younger children.
- Treatment adherence. Many children and teens are concerned about fitting in with their friends and may not think about future consequences. For these and other reasons, some have trouble taking their medication as directed. Taking HIV medicine consistently is the best way to protect health and prevent onward transmission of the virus. Many strategies can help improve treatment adherence among youth, including simpler treatment plans, text message reminders for taking pills, and support from peers with HIV.
- Prior anti-HIV treatment. Some anti-HIV treatments stop working after a period of time because the virus may become resistant to those drugs. For example, teens who got the virus at birth might harbor HIV that has become resistant to some drugs during periods when they had trouble with treatment adherence.
Several challenges make it difficult for youth to access the tools they need to get treatment and care if they have HIV.
- Youth ages 13 to 24 years are the least likely of any age group to know their HIV status. Not knowing you have HIV means you cannot take advantage of HIV care and treatment and may transmit HIV to others.
- Young people also are more likely than older people to be living in low-income households or to have been recently homeless, recently incarcerated, or uninsured. These social and economic challenges pose additional obstacles to accessing HIV treatment and prevention services.
The NICHD-supported Adolescent Trials Network (ATN) is focused on finding the best treatments for youths living with or at risk for HIV. The ATN has more information about what it does and how to participate .