Antiretroviral therapy

Antiretroviral therapy (usually called ART) is daily medication that treats HIV. It doesn't cure HIV, but it stops the virus from making copies of itself inside the body. People on ART live long, healthy lives — and most reach a point where they can't pass the virus on at all.

• ART is daily medication that keeps HIV under control. It doesn't cure it, but it works really well.
• Most people on ART reach "undetectable" status — meaning they can't pass HIV on (U=U).
• ART is free on the NHS.
• The earlier someone starts treatment, the better.
• People on ART have the same life expectancy as people without HIV.

How it works

HIV gets inside certain white blood cells (CD4 cells) and uses them to make copies of itself. ART blocks that copying process. The amount of virus in the body — the "viral load" — drops right down, and the immune system stays strong.

[DIAGRAM: Simple diagram showing how ART works — virus replicating, medication blocking replication, viral load becoming undetectable]

When ART works well (and it usually does), the viral load gets so low it's called "undetectable." This is a really big deal: undetectable means untransmittable. Someone with an undetectable viral load cannot pass HIV on during sex. This is shortened to U=U — and it's one of the most important facts about HIV that lots of people still don't know.

What treatment looks like

These days, it's usually one tablet, once a day. That's it. Older treatments involved handfuls of pills at specific times, but modern ART is much simpler. Side effects are uncommon, though some people get mild ones when they first start.

In the UK, ART is completely free on the NHS. Anyone diagnosed with HIV gets referred to a specialist clinic and can start straight away.

Things people get wrong

"If you need daily medication, you must be ill." Nope. ART keeps people healthy. Most people on it feel completely fine and get on with their lives like anyone else.

"ART cures HIV." It doesn't. It controls the virus brilliantly, but if someone stops taking it, the virus comes back. That's why it's lifelong medication. Researchers are working on a cure, but it doesn't exist yet.

Things people ask about ART

Is ART the same as PrEP?

No. ART is for people who have HIV. PrEP is for people who don't have HIV but want to protect themselves from getting it. They use some of the same drugs, but they're different treatments.

What happens if you miss a dose?

The odd missed dose isn't a disaster, but taking it consistently matters. If someone keeps missing doses, the virus can start multiplying again and might become resistant to the medication.

Can someone on ART still pass on HIV?

If their viral load is undetectable — no. U=U has been proven in large studies. That's the goal of treatment, and most people on ART reach it.

Where to get help

• Terrence Higgins Trust — info, support, and free testing for anyone affected by HIV.
• Sexual health clinics (GUM clinics) — where HIV treatment is managed. Free and confidential.
• NHS 111 — can help you find your nearest HIV or sexual health clinic.

Antiretroviral therapy, usually called ART, is medicine that treats HIV. It does not cure HIV, but it stops the virus from making copies of itself inside the body. People who take it live long, healthy lives.

The treatment is usually just one tablet a day. It is free on the NHS. Side effects are not common, though some people get mild ones when they first start.

When the medicine works well, the amount of virus in the body drops so low that the person cannot pass it on during sex. This is a really big deal. It is sometimes written as U=U, which means undetectable equals untransmittable.

ART does not cure HIV. If someone stops taking the medicine, the virus comes back. That is why it is a medicine you take for life. But most people on it feel completely well and get on with their lives like anyone else.

ART is not the same as PrEP. ART is for people who already have HIV. PrEP is for people who do not have HIV but want to protect themselves from getting it.

The earlier someone starts treatment after finding out they have HIV, the better it works. Anyone diagnosed with HIV in the UK gets help straight away.