Antiretroviral therapy (ARV): what really matters

People on antiretroviral therapy who reach and keep an undetectable viral load live longer, healthier lives and don’t sexually transmit HIV. That’s the practical goal: suppress the virus, protect the immune system, and avoid drug resistance. If you or someone you care for is starting or already on ARVs, this page gives straight, useful guidance—no jargon, just the basics you need to manage treatment day-to-day.

How antiretroviral therapy works and the main drug types

ARVs block HIV at different steps of its life cycle. Doctors combine drugs from different classes so the virus has a much harder time surviving. Common classes you’ll hear about: NRTIs (nucleoside reverse transcriptase inhibitors), NNRTIs (non-nucleoside reverse transcriptase inhibitors), PIs (protease inhibitors), and integrase strand transfer inhibitors (INSTIs). Many current regimens use one or two NRTIs plus an INSTI because they work well and usually have fewer side effects.

Some widely used single-tablet regimens combine these drugs into one pill taken once daily. That simplifies life—less to forget. Your provider will pick a regimen based on viral load, past resistance tests, kidney and liver health, other meds you take, and whether pregnancy could be an issue.

Practical tips: taking ARVs safely and staying on track

Adherence matters. Missing doses gives HIV a chance to become resistant. Use alarms, a daily pillbox, or a phone app. If you travel, carry a copy of your prescription and keep meds in their original packaging.

Watch for common side effects: nausea, diarrhea, headache, sleep changes, rash. Some drugs can affect kidneys, bones, or lipids—your clinic will check labs to catch problems early. Typical monitoring includes viral load and CD4 tests, plus baseline checks for hepatitis B/C, kidney and liver function, and resistance testing if needed.

Be careful with interactions. Antacids and some supplements (like calcium or magnesium) can reduce absorption of some integrase drugs — take them two hours before or six hours after. St. John’s wort and certain OTCs can lower ARV levels. Always tell your provider about every medicine, supplement, or herbal product you use.

Never buy ARVs from an unverified online seller. You should have a prescription and buy from licensed pharmacies. If you need lower-cost options or help with access, ask your clinic about assistance programs, generics, or local health department resources. For related supply guidance, see our guide on buying Dapsone safely—useful if you face coinfection issues or need prophylaxis under medical advice.

If you notice new symptoms, missed doses, or think you were exposed to HIV, contact your clinic right away. Rapid action can prevent problems and keep therapy working for you. Talk openly with your provider — clear communication is one of the simplest ways to stay healthy on ARVs.