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HIV treatment in women

The evidence available suggests that HIV treatment works well for women. Unless you are pregnant, the recommendations for HIV treatment are the same for both women and men.

To find out more about specific types of HIV treatment, and what HIV treatment involves, see the NAM booklets Anti-HIV drugs and Taking your HIV treatment in this series.

Since October 2012, HIV treatment has been available free to everyone in the UK who needs it, whatever their immigration status.

Taking HIV treatment

You may feel anxious about starting and taking your treatment. Discuss your concerns with your doctor and talk with other people who are already on HIV treatment. You will find out about how they successfully manage to keep taking the treatment regularly and what strategies they use to minimise any side-effects.

HIV treatment involves drugs that work very well when your adherence is good. ‘Adherence’ is a term used to refer to taking your drugs at the right time, every day, as prescribed by your doctor.

Taking your treatments every day and not missing any doses, is one of the most important aspects of managing your HIV. If you are finding it difficult to take your treatment in the right way, talk to one of your HIV healthcare team as soon as possible. You could also talk to other women who are successfully managing their treatment at home and work. Maintaining a healthy lifestyle and having a good support network are other important means of staying well.

You can find out more about managing your HIV treatment in NAM’s booklet Taking your HIV treatment.

Side-effects of HIV treatment

Like any drugs, HIV treatment can cause side-effects. It is important to always talk to your doctor or nurse and let them know whenever you experience any new symptoms that may be due to side-effects, as they may be able to help you deal with them. It is worth remembering that many women have few, if any, side-effects, especially after the first few days of a new drug when your body has had a chance to adjust to it. Newer anti-HIV drugs tend to have fewer side-effects than the older ones.

Not everyone will experience side-effects. If they do, most often, side-effects occur soon after a drug is started and lessen over time. Common side-effects include nausea, diarrhoea, headaches, rash and feeling tired. Your healthcare team should talk to you about what side-effects you might expect and how to minimise their impact.

Most side-effects are not serious. However, certain anti-HIV drugs can cause serious hypersensitivity (allergic) reactions in some people, usually soon after you start on a new drug. It’s very important you seek medical advice quickly in this situation. You can find out more about the drugs most likely to cause this reaction, and the symptoms to look out for, in the Anti-HIV drugs and Side-effects booklets in NAM’s information series.

Women tend to get higher levels of some anti-HIV drugs in their blood than men. This is probably because men tend to weigh more. Having higher levels of a drug in your blood can mean that there's more of it available to fight HIV but, on the downside, it could mean that you might be more likely to experience side-effects.

Because of possible side-effects, women prescribed certain drugs may need closer clinical and laboratory monitoring in order to avoid potential problems. If you are concerned about any aspect of your treatment, always talk to your doctor, pharmacist, support worker or treatment advocate about this and they will help you to make the treatment choices that suit you best. The side-effects listed below, while not common, are thought to affect women more often than men.

Rash and liver toxicity related to nevirapine: Women appear to be at greater risk than men of developing these side-effectslinked to the anti-HIV drug nevirapine (Viramune). These are most likely to occur in the first three months of treatment and you will be closely monitored during this time. It is especially important that you keep regular appointments at your clinic for liver function and other tests during this time.

Metabolic changes: These include changes in the levels of fat and sugars in the blood, which can result in high blood glucose, high blood pressure and increased cholesterol and triglycerides. Regular monitoring of these is important as high levels are often associated with an increased risk of diabetes, heart disease and stroke.

If you are taking HRT (hormone replacement therapy, for women going through the menopause) as well as HIV treatment, ensure that you discuss the risk factors with your doctor, as HRT can also increase the risk of stroke. There is also a possible risk of interactions between HRT and some anti-HIV drugs.  

Lipodystrophy, where fat accumulates in certain parts of the body, resulting in visible body shape changes, can be a side-effect of HIV treatment. There may also be a reduction in fat in other areas of the body, known as lipoatrophy. Some studies suggest that lipodystrophy may affect women more than men, and that women are more likely to experience unusual fat accumulation in certain parts of the body such as the breasts without the fat loss that more often occurs in men.

Body changes can be distressing. If this happens, discuss it with your doctor and talk to other women who have had, and dealt with, similar experiences.

Menstrual changes: Menstrual changes, including irregular, heavy and painful periods, are associated with some anti-HIV drugs in a group called protease inhibitors, especially Kaletra (lopinavir/ritonavir). Talk to your doctor if you have concerns.

HIV & women

Published July 2014

Last reviewed July 2014

Next review July 2017

Contact NAM to find out more about the scientific research and information used to produce this booklet.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.