Antiretroviral therapy: how ART works and what to know

If you or someone you care for is starting ART, you probably want straightforward answers: what the meds do, what side effects to expect, and how to avoid resistance. Antiretroviral therapy (ART) stops HIV from multiplying, lowers viral load to undetectable levels, and keeps the immune system stronger. That makes getting and staying on the right regimen the main goal.

Drug classes & common meds

ART combines drugs from different classes so the virus has fewer ways to survive. Common classes are:

- NRTIs (nucleoside reverse transcriptase inhibitors): e.g., tenofovir, emtricitabine, lamivudine. These are backbone drugs in many combos.

- NNRTIs (non-nucleoside reverse transcriptase inhibitors): e.g., efavirenz, doravirine.

- INSTIs (integrase strand transfer inhibitors): e.g., dolutegravir, bictegravir. These are fast-acting and often well tolerated.

- PIs (protease inhibitors): e.g., darunavir. Usually taken with a boosting agent.

- Entry/fusion inhibitors and CCR5 antagonists: used when other options are limited.

Specific drugs matter when resistance or side effects are an issue. For example, abacavir resistance is a real topic—testing and careful management help keep treatment effective.

Practical tips for staying on ART

Adherence is the single most important thing. Missed doses give HIV a chance to develop resistance. Try these practical tricks:

- Set a daily alarm or link your pill to a routine (morning coffee, brushing teeth).

- Use a pillbox that shows doses for each day.

- Refill early and keep a week’s spare supply when possible.

- Talk to your provider about side effects—many can be managed by timing, switching drugs, or simple remedies.

Monitoring matters. Viral load and CD4 tests show whether ART is working. If viral load isn't falling or rises after being undetectable, your clinician will check adherence and may order resistance testing. That helps pick the next regimen without guesswork.

Watch for drug interactions. ART can interact with common meds like some statins, antacids, or herbal supplements. Always tell every provider and pharmacist about your ART drugs before starting anything new.

Getting meds: use a trusted clinic or a verified pharmacy. Be cautious with unknown online sellers—authenticate credentials, require a prescription, and check reviews. If cost or access is a problem, ask your clinic about assistance programs or local health services that help with ART access.

Questions? Bring them up with your care team. Short, clear conversations—about side effects, pregnancy, travel, or missed doses—make treatment simpler and safer. Staying informed and connected is the best way to keep ART working for you.