In the mid-1990's, an effective treatment for HIV infection, called Highly Active Anti-Retroviral Therapy or (HAART), became widely available in Australia, radically changing the lives of people living with HIV.

From this time on, being infected with HIV has no longer meant an inevitable progression to AIDS and then death. Consequently, the annual number of deaths from AIDS fell rapidly once HAART became available. HAART has changed HIV into a long-term chronic infection that can be controlled through proper medication and monitoring.

Having effective treatment has reduced the impact of HIV for many people. But having HIV still means dealing with a wide range of problems on a day-to-day basis.

Taking Treatments

Taking HIV treatments is not easy. The treatments often need to be in particular combinations, taken at specific times of the day and night. They also often need to be matched with particular types of food. The ability to take medications on-time, all the time, in accordance with the prescription is called 'compliance'. If a person is unable to comply with the dosing requirements of their treatment, HAART may not continue to suppress HIV in their body. A high degree of compliance is needed to maintain the levels of anti-HIV medication in the body.

Missing a Dose

Missing even occasional doses can cause the level of medication in the body to drop and the amount of HIV to increase again. However, compliance to HIV drugs is very difficult because many people experience severe side-effects that disrupt their daily functioning.

Side-effects from HIV drugs can include:

• Skin rashes;
  

• Diarrhoea;
  

• Nausea;
  

• Fevers;
  

• Vomiting;
  

• Mood swings; and,
  

• Dizziness.

Some HIV+ people have been sicker on medications than they ever have been without them.

Unfortunately, over the last few years, evidence has indicated the existence of strains of HIV that have developed a resistance to drugs used in HAART therapy. This is because, on the occasions when people on HAART have forgotten - or chosen - not to take their drugs, this break in compliance has given the HIV virus an opportunity to mutate and change its structure, so that when it is exposed to the drug again, it is no longer affected by it.

Some people living with HIV have been slowly running out of combinations of HIV drugs that will work for them. Because there are more and more people living with untreatable, drug-resistant HIV as a result, some doctors are concerned that there may be an increase in deaths from AIDS in the next few years. This likelihood has encouraged many HIV doctors to delay the beginning of HAART regimes for some newly-diagnosed people with HIV.

When HAART first arrived, most doctors thought that 'hitting hard and hitting early', ie putting people on high dosages of treatments soon after they were diagnosed with HIV, was the best way to use HIV medications. But because compliance to HIV drugs is so difficult, many doctors now will not advise medication until either HIV viral load is high or CD4 count, an indication of immune function, is low.

Some HIV positive people go on and off treatment at different times so that they can tolerate the side-effects more easily. These kinds of breaks are sometimes called 'drug holidays' or 'structured treatment interruptions'. Not all HIV+ people are on HIV treatment all the time.

Because people with HIV/AIDS are living longer on treatments, and more men are getting HIV each year, more Victorian men than ever before are living with HIV.