One of the biggest life changes I had to make, after my HIV diagnosis, was adapting the habit of taking meds twice a day. But HIV meds, called Antiretroviral Treatment or ARVs, aren’t any ordinary medication. They follow a strict schedule. And you have to do this religiously to manage the virus.
For someone who has never taken pills before, it has definitely become a chore.
Last March, there were several articles in various publications and websites that presented new studies on replacing regular ARVs with monthly injections. From a report from Tech Times by Diane Samson (https://www.techtimes.com/articles/239367/20190309/injections-better-than-pills-at-treating-hiv.htm), two international research projects “confirmed that getting monthly shots is as effective as taking two pills a day.”
Then the following month, The Body released an article by Kenyon Farrow (https://www.thebodypro.com/article/long-acting-hiv-treatment-is-coming-health-care) of similar studies broaching into phase III trials for Edurant (cabotegavir and rilpivirine), the only long-acting injectable ARV treatment that has reached this phase of trials. According to POZ (https://www.poz.com/article/viiv-applies-approval-first-longacting-injectable-hiv-regimen), Viiv, the company who manufactures cabotegavir, have already filed for FDA approval and we might seeing the rollout of this new procedure by the end of the year in America.
Does that mean an end to constantly be carrying my pills whenever I leave the house? Will I no longer freak out if suddenly remember that I haven’t taken my pills yet at the prescribed time frame?
These two articles are just examples of the many articles found online about various studies in trying to make anti-retroviral treatment more convenient and aid in patient’s adherence to their medicine.
Anti-Retroviral Treatment or ARV are pills that people who are living with HIV (PLHIV) take daily to suppress the spread of HIV and help manage the virus in the body. Consistent use of ARVs can keep a PLHIV’s viral load to a level known as undetectable, which means that the virus cannot be transmitted because the amount of HIV cells are extremely low.
Adherence to the treatment is one of the leading causes as to why many PLHIV experience a resurgence of the virus in their system. Inconsistent ARV use can lead to the HIV cells adapting and gaining a resistance to the treatment. Keeping to your regiment is vital to managing this condition.
But there are many reasons why adherence is a challenging thing. Many PLHIV have not disclosed their status to people and being able to take the pills discreetly is a known obstacle, especially for people who do not live alone. Also, members of the community are given three to five months worth of medicine and changes in your schedule can sometimes get in the way of your visit to replenish your supply. You may have scheduled your next pick up way in advance but you can’t predict the future and there are some events that just pop up and cause issues with getting your meds.
And oftentimes, and I am guilty of this, there are days that get so hectic and stressful that you just forget to bring your pills with you when you leave the house to go to work.
Taking your ARV with you is just part of your routine and if you have been living with the virus for a long while now, it’s something you take for granted. But there are days when it slips your mind. It’s carelessness. You can get caught in the moment. But it happens.
So these new studies on replacing the regiment of daily pills (depending on your treatment, it can be twice a day or once a day) with a monthly injection would be a great convenience for the PLHIV community. For those who are not public about their status, there is no need to have to discreetly take their medicine when amongst friends and if they live with other people, they don’t have to hide their bottles of pills.
Removing the stress of keeping with your regiment on a daily basis is one way to really help the PLHIV community. It’s one more thing they can take out of their to-do list everyday and can help them maintain their secret if they wish to keep their status discreet.
But the medical community is also studying the possible negative side of these monthly injections like the possible cost of this method and what happens if the PLHIV misses their scheduled appointment? At the same time, injectable Edurant has to be injected in the buttock muscle (gluteus medius), which means additional training and staffing for all the clinics that will be administering these treatments.
Right now, many of these studies have been working on trial runs and have yet to be made available to the public. And while we are still far away from any sort of cure, studies like these which can lead to better treatment will alleviate the burden that comes with a daily regimen and can help PLHIV keep their undetectable status.
Blood Makes Noise