Human Immunodeficiency Virus (HIV) is a viral infection that attacks white blood cells and, if untreated, can progressively weaken your immune system. Compared to the past, the virus is now manageable and treatable, with those living with it capable of living long lives with the right medication.
However, Black people tend to be hit the hardest with HIV,accounting for 39 percent of new HIV diagnoses in 2024, despite being only 12 percent of the U.S. population. Black people with HIV are also among the least likely of any race to receive medical care within a month of diagnosis.
To reduce these care gaps, Black people need to be included in more HIV clinical research. Better representation is important because Black Americans are disproportionately affected by HIV and adequate representation helps ensure evidence reflects the population using these treatments. For example, Biktarvy, an HIV regimen, was studied in a clinical trial monitoring how it affects Black American adults with HIV.
Today, people living with HIV have multiple treatment options, including daily oral medications and long-acting injectable regimens. This guide breaks down selected HIV medications, how they work, potential side effects, dosing considerations, and ways to make paying for treatment more accessible. It also highlights research and considerations that may be relevant for Black patients, and those who love them.
While treatment options have expanded, Black Americans are disproportionately affected by HIV and adequate representation in HIV clinical research can help ensure evidence reflects the population using these treatments. This guide also includes selected medications and research that involve Black American adult patients with HIV.
Medicines:
Biktarvy | Cabenuva | Dovato | Idvynso
Human immunodeficiency virus (HIV) is a viral infection that causes gradual weakening of the immune system by latching onto CD4 cells in your body, a type of immune cell that protects you from disease. The virus then makes copies of itself, gradually destroying enough CD4 cells that help your body fight off even the smallest of infections.
HIV is typically spread through bodily fluids shared during sex without a condom or prevention medication or through shared needles and syringes. It is also possible for HIV to be spread from an infected mother to her child during pregnancy, childbirth and breastmilk. Contrary to myths, HIV is not spread from kissing, hugging, sharing food or drinks, toilet seats, or by living with someone with HIV.
The most advanced stage of HIV is acquired immunodeficiency syndrome (AIDS), where the body’s immune system has been badly damaged or a severe infection develops. Without treatment, the average person with an AIDS diagnosis is about three years, while the average person with HIV lives up to nine to 11 years, with those diagnosed in their late teens and 20s tending to live longer than those diagnosed in their 40s and 50s.
Having HIV is nothing to be ashamed of, nor is it a moral failing. It is a virus that anyone can contract regardless of race, gender, sexual orientation, character, or other protected status.
Black patients have the lowest rates of receiving medical care within a month of HIV diagnosis compared to other races, despite accounting for 39 percent of HIV diagnoses and 41 percent of HIV deaths as of 2024. It is imperative that these numbers do not become greater. The earlier you receive HIV treatment, the greater are your odds of survival, as well as protecting those you love.
Late diagnosis (stage 3) is common, accounting for roughly 22 percent of new diagnoses. The American South also accounts for just over half of HIV diagnoses and deaths, making rural Black Americans the most vulnerable. The later your diagnosis, the more likely HIV has done damage to your immune system.
The sooner you are diagnosed, the sooner you should start treatment. There are many clinics offering a rapid start, where you can begin treatment as soon as your first or second visit.
Many people can present without HIV symptoms for years, and some may get a flu-like illness a few weeks after exposure.
The only way to get an accurate HIV diagnosis is to get tested. You can receive an HIV test at your doctor’s office, a local community health clinic, pharmacies, and even at home with a personal test kit. The CDC recommends that anyone ages 13 to 64 get tested for HIV at least once, and even more if you have unprotected sex, multiple sex partners, or are frequently exposed to needles and syringes, even in healthcare settings.
There are three types of HIV tests: antibody, antigen, and nucleic acid. Antibody tests can be done with a finger prick, a mouth swab, or an at-home kit, and take the longest to receive a positive result, usually 23 to 90 days after exposure to HIV. An antigen/antibody test is taken from a lab blood draw from a vein and receives faster positive results, usually 18 to 45 days after exposure. Nucleic acid tests detect the virus the quickest, usually 10 to 33 days after exposure, but are only done under certain circumstances and are expensive to receive.7
Stigma against having HIV, especially HIV in Black populations, is a major factor in why many delay treatment or even an official diagnosis. This can also bring up unfair conversations around one’s drug use, sexuality and sexual activity, or even who “gets” HIV. This stigma can result in hiding pills and treatment from family and friends, or skipping injection appointments.
Some patients can also have concerns that storing pills in the home can be potentially dangerous or revealing of your HIV condition, livelihood and well-being. Many patients opt for injection treatments that can be received once a month or sometimes once every two months.
If the stigma of having HIV may play a role in managing your condition, be sure to bring it up to your provider. You are not required to reveal your HIV status to anyone who is not your sexual partner or part of your medical care team, and having HIV, especially as a Black person, is nothing to be ashamed of.
There is currently no cure for HIV, so the goal of HIV treatment is to live a long, healthy life with an undetectable viral load that prevents transmission to a sexual partner. When a person takes HIV treatment as prescribed and maintains an undetectable viral load, they cannot transmit HIV through sex. Remember, U=U: undetectable = untransmittable.
There are around five standard classes of HIV drugs that work depending on the stage of the virus’ lifecycle, and many treatments combine multiple medicines from different classes, typically into one easy-to-take pill.
There are many medications available to treat HIV, and this guide does not cover every option. Your healthcare provider can help determine which treatment is appropriate for you.
There are two main ways to take HIV medication.
Most HIV patients take a daily pill by mouth at home, with or without food. Pills like Dovato, Idvynso and Biktarvy contain two to three drugs in one tablet and are a complete regimen.
Some HIV medicines are given as intramuscular shots by a healthcare provider rather than taken at home, anywhere from every month to every six months depending on the medicine. Cabenuva is an example of an injectable regimen for people already on HIV pills who have an undetectable viral load and no history of treatment failure or resistance.
While medication is at the center of a HIV regimen, those with HIV should also receive:
As a reminder, having HIV is not a moral or personal failing. Absolutely anyone can have HIV, and it is not reserved for a specific kind of person. In order to properly care for yourself during HIV treatment:
Questions to Ask Your HIV Healthcare Team
To be Black with HIV is to be somewhat of a majority within a minority. Knowing and understanding your treatment options can make a world of difference in your overall health and happiness. The sooner you can receive treatment, the greater the odds of a long, healthy life.
The medicines in this guide are just a small frame of reference to the possibilities of treating and living with HIV. They all have varying benefits, side effects and monitoring requirements that you should discuss with your healthcare provider to know what will work best for you.
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking any drug or commencing or discontinuing any course of treatment.
Human immunodeficiency virus (HIV) is a viral infection that gradually weakens the immune system by latching onto CD4 cells in your body, a type of immune cell that protects you from disease.The most advanced stage of HIV is acquired immunodeficiency syndrome (AIDS), where the body’s immune system has been badly damaged or a severe infection develops.
For most regimens, yes, HIV medication is safe to take while pregnant. Some newer HIV medicines have less pregnancy data than others, so be sure to ask your doctor about what would be right for you and your baby.
Some common mild side effects of HIV medication include headaches, nausea, diarrhea, tiredness, and trouble sleeping, which usually go away within the first few weeks. For those taking injectables, soreness or a lump at the injection site can happen. If you have any yellowing of the skin or eyes, dark urine, severe stomach pain, any widespread rash with fever or blistering, or new or worsening depression or thoughts of self-harm, contact your doctor immediately.
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