A Patient’s Perspective: Switching From Oral Therapy to Long-Acting Injectable ART

Key Takeaway:

• Switching to injectable antiretroviral therapy was the right choice for my self-esteem, for my travel schedule, and for me to maintain my privacy and to choose who in my life knows my HIV status.

I have been taking medicine for HIV for 9 years, and because I must take it on time, it has always been inconvenient. When traveling to different time zones, it was difficult to identify the right time for my body and whether to take it after dinner or before going to sleep. The pills always reminded me that I was sick. I know that I can live a full life with HIV, but at the same time, taking the daily pills reminded me that I need to be treated. I also noticed that during some periods of my life, taking my treatment greatly impacted my self-esteem. I am young, but something was already wrong with me.

I first heard about injectable long-acting antiretroviral therapy from friends who had started to take the shots. It is dosed only every 2 months. I decided to try it because I believe in our scientists—that they do a great job and that one day they will find the cure for HIV.

My pharmacist and doctors explained how the transition is very safe and that I would be given the pill form (oral lead-in) first so that I could try the drug and check my reaction. If I reacted badly, the treatment could be stopped immediately. In this way, the drug would have a minimal negative impact on my health. My blood was tested to see how the new treatment affected the virus (ie, monitor my viral load).

It seemed like a safe approach, and I felt that I could stop it at any time. I could just listen to my body and see how the treatment worked. When I decided to try it, I was thinking only about the positive impacts of getting just 6 shots per year—it sounded magical after having taken pills every day for 9 years. I could forget about the treatment’s scheduled time, the time zone, and the inconvenience of taking daily medications. It really sounded like a new level of life quality, and I was excited about it.

I got the first shot, and I did not have any bad feelings. Since the first month, I have not been taking the daily pills, and it is very important to me to feel that I no longer need to think about that. I am no longer reminded on a daily basis that something is wrong with me and that I am sick. I no longer need to hide my pills from my friends when they come over, as I do not want share about my disease.

On Going to the Clinic for Injections
I schedule the shots at the appointment with my nurse. Because the time period in which to receive the shot is within 7 days before or after the scheduled appointment time, it is convenient and allows some flexibility. Even if you have a difficult schedule with travel, like I do, the injection schedule works great. I am so happy that I got this opportunity—it really changed my quality of life and supported my self-esteem and my psychological feelings in a positive way.

On Missing an Injection
If I miss an injection, I can get the pill form of this medication. I also can get the pills if I am traveling or need to postpone my shot appointment. These options make it very convenient.

On HIV Medication, Family, and Friends
My husband and my parents know that I have HIV and that I take HIV medicine. I used to keep my pills in the bathroom or in the bedroom, and I had noticed that when we invited our friends to our apartment, my husband tried to hide my medications. But I have noticed that I also do not want have my medications seen because I think it is not necessary. It is not because I want to hide my illness—my HIV—from them. We just want to have a good time together, so I think it is not always necessary to dive into certain health topics. I have been taking my HIV medication for more than 9 years, and I know how to take care of myself.

I have noticed that other people having knowledge of my HIV status might separate me from them, and this makes me feel that because of HIV, I am not like other people. This is why I choose who in my life knows my HIV status. Injectable therapy has made this even easier for me.

Your Thoughts?
In your practice, how have patients with HIV reacted to the idea of changing from daily oral medications to injectable long-acting antiretroviral therapy? Join the conversation by adding a comment or question below.