The outlook for people with HIV in the UK has never been better. The right treatment and care can mean that you have a good chance of living a long and healthy life, with a near-normal lifespan.

The currently available anti-HIV drugs (‘antiretrovirals’) cannot cure HIV. However, treatment with a combination of these drugs (usually three) can reduce the amount of HIV in your blood (your viral load) to such a low level that it cannot be detected using laboratory tests. This is called an ‘undetectable’ level. An undetectable viral load is the aim of HIV treatment. Having an undetectable viral load means that your immune system can stay strong and fight off infections.

There’s very good evidence that the HIV treatment available today will work against the virus in the long term and keep your viral load undetectable indefinitely.

However, for this to be the case, it’s very important to take your HIV treatment properly. This is often called ‘adherence’ and it is the most important factor under your control in the success of your HIV treatment.

Not taking your HIV treatment properly can mean that the levels of the drugs in your blood are not high enough to properly fight HIV. If this happens, your HIV will be able to reproduce. The strains of HIV that reproduce when you’re taking HIV treatment can develop resistance to the drugs you are taking. Resistance can mean that your HIV treatment won’t work properly.

Your treatment not working is likely to mean that your viral load will increase and your CD4 cell count, an important indicator of the health of your immune system, will fall. This situation increases your chances of becoming ill because of HIV.

If your viral load increases to detectable levels, then you’ll need to change your HIV treatment. While there is more choice available now, this new treatment might be more difficult to take than the combination you were taking before and could involve a risk of more or new side-effects.

You may also become resistant to drugs similar to those you are currently taking. This is called cross-resistance and the risk varies between different classes of HIV drugs. You can find out more about the different drug classes in the NAM booklet Anti-HIV Drugs .

When taken properly, HIV treatment can also lower viral load in genital fluids to undetectable levels. This can reduce the risk of HIV transmission during sex. A consequence of not taking your HIV treatment properly can be that the amount of virus in your genital fluids increases, therefore increasing the risk of passing on HIV to your sexual partner(s) and the type of HIV which you pass on may be resistant to one or more of the drugs.

There’s more information about resistance in the second part of this booklet.

You can find out more about HIV treatment in the NAM booklet Anti-HIV Drugs. Information about CD4 cell counts and viral load is available in the booklet CD4, Viral Load & Other Tests .