Choosing which HIV treatment regimen is right for you might seem like a real head-scratcher. There are so many variables to consider: whether you want to take your pill at night, how big a pill you are comfortable taking, whether you want to take your pill with food or on an empty stomach, just to name a few. And then, of course, with long-acting injectables on the market, you might opt not to take a pill at all and instead visit your doctor’s office every month or every other month, depending on your preference.
Knowing about the many treatment options available to you is not only possible but fairly easy, especially with tools such as POZ’s HIV Drug Chart. But the best tool in your arsenal is someone you probably already know: your medical provider. “The relationship with your medical provider is one of the most important relationships that you will have,” says Jeffrey Kwong, DNP, MPH, a clinician and professor of advanced nursing practice at Rutgers University. “The person that’s sitting across from you should be copiloting and helping you navigate.”
When it comes to helping patients, Kwong thinks of his work as akin to that of an interior decorator—no, really. “If you consult an interior designer, you want some choices or ideas and they kind of weed through all the different things for you and say, ‘Here are five great options,’” he says.
When discussing treatment choices with his patients, Kwong first considers some of the factors that are not changeable in a patient’s medical history, including whether they have drug resistance or they have other chronic conditions with regimens that might interact with HIV treatment. After that, it’s up to patients to share their preferences that best fit their lifestyle, including which side effects they’re willing to tolerate, how often they are willing to take a pill, when they want to take the pill and how they feel about pill size. “In the end, it comes down to the person who is going to be taking it every day,” he says. “They need to make the choice. But I help guide them in terms of narrowing down.”
To that end, Kwong says, picking a good provider might be one of the most important steps in finding the right regimen. “If you don’t trust, if you don’t feel comfortable, if you don’t feel open enough to share important and salient aspects of yourself, then I would consider trying to find someone you can make those connections with.”
That goes both for people who are newly diagnosed and choosing their first treatment and people who might be considering switching. If there are aspects of your current regimen you do not like, Kwong says, it’s important to be honest with your doctor as well as specific about what doesn’t work for you. Even if it’s something you think is small, such as that the pill leaves a bad taste in your mouth or you want to be on the same pill as your partner, your patient-doctor relationship should be one that makes it possible for you to air your grievances.
While choosing an HIV treatment can be daunting, approaching it with the mindset that you are in the driver’s seat while your doctor is alongside you can be very helpful. After all, this is a collaboration, and you should only collaborate with someone you trust with your health.
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