Considering Treatment and Your Health Care (Additional PLUS Reading Materials)

BOOKLET 2 OF 3

HIV HEALTH & WELLNESS

Considering treatment
and your health care

JANUARY 2013

your life matters

Table of contents

Using this booklet ... 2
How is today different from earlier in the epidemic? 3

KNOWLEDGE: Understanding the details of treatment
Why take HIV medications? 4–5
Choosing the best time to start 6–7
When to start: CD4 count ranges 8
Classes of HIV meds 9
Recommended regimens for first line treatment 10
A few things about your first regimen 11
Understanding test results 12
Resistance testing before starting 13

HEALTH: Your ability to start and maintain
Women and HIV infection 14–15
Are you ready to start? 16
Side effects from HIV meds 17
Drug interactions 18

SELF-ADVOCACY: Getting ready to start
Getting your health care covered 19–21
Is your doctor experienced in treating HIV? 22
Important questions to ask others 2

RESOURCES:
Checklist for getting started 24

HIV Health & Wellness: Considering treatment and your health care 1

Using this booklet ...

The main focus of this booklet is to get you thinking about
HIV and your health. Because treating HIV can be complex
and because only you can take the medicines your body
needs, your ability to commit to the meds are a critical part
of your health decisions.
Getting the earliest treatment is generally recommended
for most illnesses. HIV may not be any different; except that
once it’s started, treatment is for life. On one hand, deciding
the best time to start HIV meds is a matter of personal
choice. On the other, study results increasingly lean toward
starting earlier.
Some experts believe that starting meds is appropriate
immediately after finding out your diagnosis. Waiting
might allow HIV to progress further and do more damage
to your immune system and to other body systems and
organs such as your heart, blood vessels and kidneys.
At a minimum, most doctors would agree that it’s neces-
sary to start meds when HIV symptoms are present, your
CD4 count is falling, or your viral load is high and rising.

HELPFUL RESOURCES

Just Diagnosed Resource Center www.thebody.com/content/art49985.html

2 HIV Health & Wellness: Considering treatment and your health care

How is today different
from earlier in the epidemic?

Treating HIV is very different today
than what it was earlier in the epi-
demic. People are now healthier and
living longer on HIV meds, and
many can start with a full regimen
of just one or two pills taken once
or twice a day. There are fewer food
restrictions, and drugs are generally
easier to take and tolerate.
Perhaps some of the things you believe about today’s
medicines are not — or are no longer — true. Concerns
still linger in the community about severe side effects and
how someone might look after being on meds for awhile.
Newer regimens generally have fewer and more manage-
able side effects. The drugs that caused the most problems
are rarely used for people starting treatment in the US.
Over the years, public health care programs as well as
private health insurance have greatly improved their HIV
care, allowing more people to find and pay for stable medi-
cal care. The medical community also has a great deal more
experience treating HIV today.


Why take HIV medications?
Although most people don’t have outward symptoms
of HIV for many years without being on treatment, it’s
extremely rare that the immune system can fully sup-
press HIV on its own. The longer you have untreated
HIV the more damage it can do, making you more
susceptible to infections and other health problems.

IMPROVING QUALITY OF LIFE
Being on HIV treatment
should interfere as little as
possible with your quality
of life. It should be easy
enough to use so you can
take every dose as prescribed. For most people, it’s
possible to find a regimen that works well with mini-
mal side effects or drug interactions. If you cannot
tolerate a drug or the regimen isn’t working for you,
it’s possible to switch to other options.

IMPROVING IMMUNE FUNCTION
Taking HIV treatment normally produces a higher
CD4 count. Some people experience a rapid rise in
their CD4s after starting treatment, but for others the
increase may take more time. This is especially true if
you wait to start treatment until your CD4 counts are
very low, such as below 100.


REDUCING VIRAL LOAD
HIV treatment makes it easier for the immune system to
control HIV. The goal is to keep HIV levels as low as
possible for as long as possible, preferably below 50 copies
(called undetectable). The minimum change that shows
treatment is working is lowering your virus level by 90%,
or a 1 log decrease (such as 10,000 down to 1,000).

REDUCING DRUG RESISTANCE
When HIV is fully suppressed by HIV meds, it’s less
likely to change and become resistant to the drugs.
Taking every dose as prescribed and staying undetect-
able can help prevent resistance. Most commonly
used HIV meds are so good now that they’re able to
overcome drug resistance for many years even with
one or two doses missed every once in a while.

HELPING PREVENT TRANSMISSION
People who take HIV meds and stay undetectable are
less likely to transmit HIV. However, even with good
adherence to an HIV regimen, there’s still some risk in
transmitting HIV — for
example, active sexually
transmitted diseases
(herpes, syphilis, etc.)
can increase the risk. It’s
important to continue
engaging in safer sex.


Choosing the best time to start

The following factors can help you and your provider
choose the best time to start treatment.

YOUR CD4 COUNT TREND
A trend is when you
look at two or more
CD4 count results to
see how much they
change. Over time,
falling CD4s indicate
declining immune
health. A loss of 100
CD4s or more each
year shows a weakening immune system. Don’t panic
about a single lower test result, but consult with your
doctor and consider another test to determine your
trend. (Read more on page 8.)

YOUR VIRAL LOAD TREND
Increasing HIV levels over time indicate that the virus
is reproducing and can infect more CD4s. Again, the
trend is important: consider two or more test results
to inform a treatment decision. Experts generally agree
that viral load rising above 100,000 is a sign to start.


YOUR GENERAL HEALTH
If your health is good and stable, then starting treat-
ment right away may not be necessary. But if you
have some symptoms of HIV disease, despite a good
CD4 count, starting is usually the right decision. On
the other hand, if you have an illness that may make
it difficult to take HIV meds, it may be better to wait
until that illness has resolved. Your doctor can help
you make this decision.

ARE YOU READY TO START?
You should begin treatment when you feel you’re ready,
but you shouldn’t put it off until all your fear is gone.
Being ready includes being emotionally ready to com-
mit over the long-term, as well as being able to take
pills every day, manage possible side effects, and make
sure you have ongoing health care. It might also mean
dealing first with other issues such as finding stable
housing or mental health or substance use services.

THESE CONDITIONS INCREASE THE URGENCY TO START:


When to start: CD4 count ranges

STARTING TREATMENT BETWEEN 0–350 CD4 CELLS
Waiting to start until a CD4 count drops below 350 puts you
at much higher risk of developing many health problems. These
can include conditions related to HIV (pneumonia, certain
cancers, etc.) and other conditions (heart attacks, kidney
disease, etc.). Almost all doctors would agree that people with
low CD4 counts should start treatment as soon as possible.

STARTING TREATMENT BETWEEN 350–500 CD4 CELLS
The risk of getting sick isn’t quite as high in this range.
Fewer studies confirm the benefits of starting in this range
compared to lower CD4s. For this reason, you may have more
time to get ready to start. However, it’s important to under-
stand that some studies suggest your risk of getting sick is
higher if you don’t start in this range. Longer-term damage
to your body is occurring as long as HIV is not kept low.

STARTING TREATMENT ABOVE 500 CD4 CELLS
A couple of studies show a lower risk for getting sick in
people who start this early. Many other studies show that
early damage to your immune system and other parts of
the body happen when HIV isn’t well controlled — no mat-
ter the CD4 count. As well, people who are on treatment
with undetectable HIV are much less likely to pass on HIV
to their sex partners. However, even though the risk of side
effects is much lower with modern treatment, taking meds
longer could increase your chance of developing certain
side effects. It’s reasonable for someone to start above 500,
but the pros and cons should be carefully considered.


Classes of HIV meds

Your first regimen will probably include three drugs from
two different classes. These classes work against different
steps in the life cycle of HIV. Using at least two classes to-
gether provides better and longer-lasting health.
Below is the current list of HIV meds, organized by class
and then listed by brand name, generic name and year of FDA
approval. Some drugs are no longer used or not used often
in the US, while others are used only in special situations.

NRTIs (nucleoside/nucleotide NNRTIs (non-nucleoside
reverse transcriptase inhibitors) reverse transcriptase inhibitors)
Emtriva (FTC, emtricitabine, 2003) Edurant (RPV, rilpivirine, 2011)
Epivir (3TC, lamivudine, 1995) Intelence (etravirine, 2008)
Retrovir (AZT, zidovudine, 1987) Rescriptor (delavirdine, 1997)
Videx EC (ddI, didanosine, 2004) Sustiva (EFV, efavirenz, 1998)
Viread (TDF, tenofovir, 2001) Viramune (nevirapine, 1996)
Zerit (d4T, stavudine, 1994)
ENTRY INHIBITORS
Ziagen (ABV, abacavir, 1998)
Fuzeon (T20, enfuvirtide,
PIs (protease inhibitors) injectable, 2003)
Aptivus (tipranavir, 2005) Selzentry (maraviroc, 2007
Crixivan (indinavir, 1996) FIXED DOSE COMBINATIONS
Invirase (saquinavir, 2003) Atripla (TDF+FTC+EFV, 2006)
Kaletra (lopinavir/r, 2000) Combivir (AZT+3TC, 1997)
Lexiva (fosamprenavir, 2003) Complera (RPV+TDF+FTC, 2011)
Norvir (ritonavir, 1996) Epzicom (3TC+ABV, 2004)
Prezista (darunavir, 2006) Stribild (ELV+TDF+FTC, 2012)
Reyataz (atazanavir, 2003) Trizivir (AZT+3TC+ABV, 2000)
Viracept (nelfinavir, 1997) Truvada (FTC+TDF, 2004)
INI (integrase inhibitor)
elvitegravir (ELV, 2012)
Isentress (raltegravir, 2007)
HELPFUL RESOURCES

AIDSMeds.com www.aidsmeds.com/list.shtml


Recommended regimens for first
line treatment (updated March 2012)

The Guidelines list “preferred” and “alternative” HIV regi-
mens. Research shows that “preferred” regimens are potent,
better tolerated and easier to take. These are listed below.
“Alternative” regimens are second choices but may work
just as well. These can be found in the Guidelines.

PREFERRED REGIMENS

NNRTI: Atripla (1x/day), 1 pill
Women should get a pregnancy test done before start-
ing this pill. One of the drugs in it, Sustiva (efavirenz),
can cause birth defects.

PI: Prezista/Norvir + Truvada (all 1x/day), 4 pills

PI: Reyataz/Norvir + Truvada (all 1x/day), 3 pills
People who are taking more than 20mg of omeprazole
(an antibiotic) should not start Reyataz.

INI: Isentress (2x/day) + Truvada (1x/day), 3 pills
This regimen is a little unusual in that one pill is taken
once a day while the other is taken twice a day. People
should not take both pills of Isentress 1x/day because it
does not control HIV as well as taking one pill 2x/day.

Pregnancy: Kaletra + Combivir (all 2x/day), 4 pills

HELPFUL RESOURCES

Guidelines for Treating HIV in Adults www.aidsinfo.nih.gov/guidelines/

more recent updates to the Guidelines for preferred regimens.


A few things about your first regimen

The most powerful and long-
lasting control of HIV comes
from a person’s first regimen
if taken properly. The longer
a person can stay on it with-
out major side effects or drug
resistance, the better.
To tell if your regimen is
working, you should see a
90% drop in your viral load
within a month or two. (See
page 5.) Most people can reach an undetectable level within
six months, although it may take up to a year if you’re over 50
or have another condition like hepatitis C.
When a person’s viral load remains undetectable for at
least one year on treatment, it usually remains that way for
at least another two years, assuming they take their meds as
prescribed. Some people have been able to stay on their first
regimen for up to eight years without having to switch. This
is true for almost any regimen.

_______ MAIN POINTS TO REMEMBER _______

control of HIV.

should drop by at least 90%.

months.


Understanding basic test results

VIRAL LOAD TEST
A viral load test is used to check how well treatment is con-
trolling HIV. It measures the number of copies of HIV in
a small amount of blood. People starting treatment for the
first time usually see their viral load fall to an undetectable
level within 12–24 weeks. Several things can influence this,
including taking the meds as prescribed and the potency of
the regimen. Higher viral loads may take longer to respond.
CD4 CELL COUNT
HIV treatment helps to preserve and increase your CD4
count, which means the immune system is getting better
at controlling HIV and other infections. The actual increase
will vary from person to person. If you start treatment with
a lower CD4 (below 200) it usually takes more time to reach
higher counts, or you may not see a large gain. Older people
and those with hepatitis C may also have smaller gains.

CD4 PERCENTAGE
The CD4 percentage shows the proportion of all white blood
cells that are CD4s, which in people living with HIV averages
about 25% or more. This marker tends to change less often be-
tween tests than the CD4 count, and it may be more reliable.
A decreasing CD4% over time shows a weakening immune
system, and one that falls below 14% is an AIDS diagnosis.

HELPFUL RESOURCES

Blood Work www.projectinform.org/publications/bw/
Understanding Lab Results www.thebody.com/content/art14477.html


Resistance testing before starting

Drug resistance occurs when HIV mutates,
or changes enough so that a drug or
regimen doesn’t fully control it any-
more. Resistance usually occurs when
drugs are not taken as prescribed and
consistently on schedule. Some people
(about 1 out of 9 per year in the US) get
a strain of HIV with some level of resis-
tance. However, HIV is rarely resistant
to all HIV meds, so learning ahead of time which drugs it is
resistant to (if any) can help you choose the best regimen.
The US Guidelines recommend that people get a geno-
typic resistance test before they start or change treatment.
People who choose HIV meds guided by resistance test
results have better control of HIV over time. To run a resis-
tance test, you must have a viral load above 1,000. The test
cannot be done accurately if viral load is below 50 copies.


your doctor make better treatment decisions.

done when viral load is above 1,000.

HELPFUL RESOURCES

HIV Drug Resistance Tests www.projectinform.org/publications/resistance/
HIV Drug Resistance Mutations www.iasusa.org/resistance_mutations
HIV Drug Resistance Database http://hivdb.stanford.edu


Women and HIV infection

HIV meds have not
been studied as much
in women. Some
questions remain
about the doses given
to women. Female
hormones may also
affect HIV meds.
However, the recommendations for when to start and
what to choose are generally the same for both sexes.
Women who are not pregnant, planning to become
pregnant, breast-feeding or taking hormonal birth
control can follow the same guidelines as men.
Women sometimes experience both a higher rate
and different types of side effects from HIV meds
than men, likely due to differences in their weight and
body size. In some cases side effects can persist longer
for women than for men, but usually decline over time.
Oral contraceptives can interact with some HIV
meds. It’s not clear whether this actually raises the
risk of unintentional pregnancy, but some experts
recommend that prescriptions should be changed or
other forms of birth control should be used.


With careful planning and ongoing care, pregnant
women can expect to have a safe pregnancy and to give
birth to an HIV-negative baby. Although HIV meds
have not been well studied in preg-
nant women, the US Guidelines rec-
ommend that all pregnant women be
on treatment to protect themselves
and their unborn babies. Some meds
appear to be safer, some can be more
problematic, and a few others should
not be used at all. When making
decisions around pregnancy, delivery
and nursing, it’s wise to consult an
HIV-experienced doctor, such as
an OB-GYN who has treated HIV-
positive women.


for women and men.

effects than men.

as birth control pills, pregnancy, delivery and nursing.


Are you ready to start?

It can be hard to take medicines and stay on them when you’re
feeling well. It’s easier to remember and take them when you
feel sick because you want to feel better. But HIV meds are
taken every day — whether you feel good or feel bad.
It’s difficult to fully grasp the meaning of “lifelong” treat-
ment, but once you start HIV meds you need to stay on
them. How do you feel about taking pills every day? Have
you taken other medicines or vitamins long-term? How
about family or friends? What were their experiences?
Adjusting to several changes in your life at once can be
hard. You may want to avoid starting meds before disrupt-
ing life experiences like going on vacation, moving or start-
ing a new job. What flexibility do you have with commit-
ments like caring for children or volunteering? How will
you carry your meds?
It’s generally better to not start until you’re ready rather
than to start and stop. You’re the expert on when you can
start in a way that helps ensure your quality of life.

STIGMA
For many, privacy is an important consideration when
taking HIV medicines. Taking them on time every day
or going to regular doctor visits may raise suspicions of
some people in your life. Discrimination or disapproval
from others can make it challenging to take care of your-
self. When possible, discretely telling people who sup-
port you may help you stay healthier.


Side effects from HIV meds

Modern HIV regimens generally have
fewer and more manageable side effects,
and many people tolerate them quite
well. Although most people wonder or
worry about side effects, it’s impossible
to predict who will have them. Some
people have few or no side effects, while
others have ones that are more troublesome for them. The
side effects one person has from a particular medicine does
not mean everyone else will have the same ones.
Short-term side effects (headache, fever, nausea, etc.) nor-
mally appear during the first few weeks of taking a new drug.
They often get better or disappear as your body gets used to
the meds. They can reappear due to stress or other infections.
People with better overall health usually experience
fewer short-term side effects. If you start later when you’re
less healthy, you may experience more side effects. How-
ever, if your regimen interrupts your quality of life, you can
probably switch to another one that you can tolerate better.
You and your doctor will keep track of long-term side
effects with routine blood tests. These can include changes
in blood fats or in certain blood proteins (such as ALT,
AST, amylase and creatinine) that point to possible problems
with certain organs, including the liver and kidneys. Over
time, these changes can progress to other conditions like
more fragile bones or kidney and liver disease.

HELPFUL RESOURCES

Dealing with Drug Side Effects www.projectinform.org/publications/sideeffects/


Drug interactions

Drug interactions are possible whenever you take two or
more drugs together, whether they’re prescriptions, over-
the-counter drugs like cold medicine, recreational drugs or
even herbal products. Even food can interact with drugs.
The more meds you take, such as meds for high blood pres-
sure or even erectile dysfunction, the more likely you could
experience an interaction. This is also true about taking HIV
meds with some herbal products, especially St. John’s Wort.
Not only does each drug or herb have its own possible
side effects, they may also increase or decrease the effec-
tiveness of other drugs. Drug interactions are not always
considered when making treatment decisions, but they can
certainly play a major role in its success.
Make sure your doctor knows about all the drugs and
supplements you take, including over-the-counter products
and recreational drugs. Your pharmacist can also be a good
resource. Drug interaction tools are also available online.


drugs or herbal products.

meds to avoid or correct drug interactions.

HELPFUL RESOURCES

HIV Drug Interactions www.hiv-druginteractions.org
Medwatch www.fda.gov/medwatch


Getting your health care covered

You may never need to file for disability, but for simplicity we
present these options in terms of pre- and post-disability.
Disability is a formal claim that must be made with your
doctor and approved by Social Security. To find programs you
may be eligible for, it’s important to consult local resources
such as benefits counselors, case managers, social workers
or attorneys as programs differ greatly from state to state.

IF YOU HAVEN’T FILED FOR DISABILITY …

GROUP INSURANCE THROUGH YOUR EMPLOYER
If your employer covers health care, the insurance company
must cover you even if you have a pre-existing condition like
HIV. There are three types of plans: fee-for-service, preferred
provider organizations (PPOs), and health maintenance
organizations (HMOs). Plans vary in what they offer, their
fees and your choice of doctors. Choose a plan that is best
for you, and check your plan for HIV-experienced doctors.
COBRA
If you leave work due to a layoff and had insurance, then
you should be offered a continuation policy called COBRA,
which is meant to sustain you until you get other insurance.
INDIVIDUAL PRIVATE INSURANCE
Individual plans are an option, but few people with HIV
can purchase them due to high cost and restrictions on pre-
existing conditions. If you had coverage before your HIV
diagnosis, it’s likely most or everything you need will be
covered. However, out-of-pocket expenses may be high.


Getting your health care covered, cont.

HIGH RISK INSURANCE POOLS
This program covers people who can’t get insurance due to
pre-existing conditions and operates in 36 states. In addi-
tion, under health care reform each state has a Pre-existing
Condition Insurance Program (PCIP) in place until 2014
when the large coverage expansions will occur.
FEDERAL RYAN WHITE PROGRAM
Ryan White funds a broad range of HIV services in states and
localities, depending on their unique needs. It’s intended
to help under- or uninsured people. If you have insurance,
you may get help with premiums or other out-of-pocket
costs. If you don’t have insurance, your state program may
help you purchase it. You may also get free or very low cost
care through HIV clinics and the AIDS Drug Assistance
Program (ADAP). Ryan White may also fund dental and
vision care. Check with your state AIDS program or ASO
to see if a Ryan White program can help you.

IF YOU HAVE AN APPROVED DISABILITY CLAIM …

COBRA
If you leave work due to disability and had insurance, you’ll
be offered COBRA until you can get other insurance like
Medicare. Coverage is often expensive. Check with a local
ASO or state AIDS office for programs to help with out-of-
pocket costs.
MEDICAID
Most people with HIV qualify for Medicaid through its
disability category, although some women with children
can qualify through a different program. Nearly all states


Getting your health care covered, cont.

require a disability claim, income and assets below a certain
level to qualify. Several states offer Medicaid to all childless
adults (AZ, DE, HI, MA, NY and VT), while several others
offer some benefits. States vary greatly in what they cover
and who qualifies.
MEDICARE (www.medicare.gov)
If you have held a job, you’ll likely qualify for Medicare.
However, you must wait 29 months after your disability
claim, during which you may be able to get your health care
through COBRA, Ryan White or Medicaid.

OTHER POSSIBLE SOURCES OF HELP

PATIENT ASSISTANCE PROGRAMS (PAPs)
PAPs are run by HIV drug makers to supply meds to
people who are under- or uninsured. They differ widely
in eligibility. These are not ideal for the long-term but can
help in the short-term or in an emergency.
VETERANS ADMINISTRATION (www.hiv.va.gov)
If you’re a veteran or family member, you’re eligible for care
through the VA. VA sites are only found in some areas and
vary in their ability to provide HIV care. As a veteran, you can
access Ryan White programs, but if your VA facility is acces-
sible and offers quality HIV care, it may be a good option.

HELPFUL RESOURCES

Welvista (access HIV meds for those on ADAP wait lists) www.welvista.org
Federal resource on health care www.healthcare.gov
Pre-existing Conditions Insurance Plans www.pcip.gov, www.pciplan.com
List of PAPs for HIV meds www.fairpricingcoalition.org
Social Security Administration www.socialsecurity.gov


Is your doctor experienced
in treating HIV?

You will need to find a doctor who’s able and willing to treat
HIV, ideally one who already has experience with HIV.
Depending on how and where you get health care, you may
not have many choices.
Experienced doctors usually keep up with recent develop-
ments in treating HIV. They also have a better sense of
preventive health care. If you can, it’s also important to find
other doctors like gynecologists, eye doctors and dentists
who have HIV experience.
Doctors with less or no HIV experience may need to
consult resources that can help them provide the best
medical care for you. Resources are available that can help
you and your doctor make informed decisions.
The WarmLine (National HIV/AIDS Clinicians’ Consul-
tation Center) provides expert clinical advice to medical
professionals. It’s available Monday–Friday, 8am–8pm,
Eastern Time. (See below.)

HELPFUL RESOURCES

WarmLine 800-933-3413 (for doctors only),
www.nccc.ucsf.edu/about_nccc/warmline/
AIDS Education Training Centers www.aids-ed.org
Clinical Care Options www.clinicaloptions.com
GLMA’s Find a Provider www.glma.org, click FIND A PROVIDER
HIVMA’s Find a Provider www.hivma.org, click FIND AN HIV PROVIDER
AAHIVM’s Find a Provider www.aahivm.org, use REFERRALLINK at right


Important questions

FOR YOUR DOCTOR: FOR OTHERS:
Do you start every Have you started on HIV
patient on treatment at meds? Why or why not?
the same time, or on the What was important
same regimen? Why or for you to understand
why not? to help you make a
Should I be concerned decision about starting
about HIV meds inter- meds?
acting with other drugs When did you know it
or herbs that I’m taking? was the right time to
Should I be concerned start?
about drug resistance, What other ways do you
and how do I keep keep yourself healthy?
ahead of it?
Do you know of support
What tests or prescrip- groups or agencies that
tions are covered by my help people talk about
insurance (public or these decisions?
private)?
How do you make sure
How do blood tests you take every dose of
inform my decision to your meds every day?
start treatment?
How did your blood
What vaccines do you
work inform your deci-
recommend I get? Why?
sion to start?
What if I’m not ready to
Did other things affect
start treatment?
your treatment decision?
Are there are any other
tests that I should take What HIV treatment
before starting an HIV information do you rely
regimen? on? Why?


Checklist for getting started

I am (am not) ready to start taking HIV meds, and under-
stand the reasons why I want (don’t want) to start.
My CD4 count is _______.
The trend is stable, increasing, decreasing.
My viral load is _______.
The trend is stable; increasing; decreasing.
I have a good understanding of the risks and benefits of
starting treatment according to my individual needs.
I have thought about how HIV treatment may impact my life.
I’ve considered the issues around taking HIV meds and oral
birth control, or HIV meds and pregnancy.
I have private or public insurance or another way to cover
the cost of my doctor visits, medicines and blood work.
I know where to go to get other types of support, like
mental health or housing services, that will help me stay
healthy.
I will ask how to properly take my medicines.
I understand how my doctor and I will check to see if my
regimen is working.
I know what side effects may give me the most problems, like
nausea or diarrhea, and which likely get better over time.
I’m aware of what I can do to help avoid or lessen side effects.
If I want privacy when taking my meds, I’ve thought about
how to ensure that.
If I have questions and my doctor is not available,
I can call _________________ or __________________.


273 Ninth Street
San Francisco, CA 94103

www.projectinform.org/HIVhealth/

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