Why Taking ART for HIV as Directed Matters

Learning About Taking ART 

This activity is for people who are living with HIV or anyone who wants to learn, or learn more, about taking antiretroviral therapy (ART) for HIV. The goal of this activity is to help you talk to and work with your doctor and healthcare team about the importance of taking treatment for HIV as directed.

You will learn about:

  • What ART for HIV is and how it works

  • What U = U means

  • Why taking ART as directed is important

  • Tips for taking ART as directed

  • Talking to your doctor and healthcare team about ART and your treatment plan for HIV

Test Your Knowledge 


Antiretroviral therapy -- or ART, for short -- is medicine used to help treat HIV. ART works by stopping HIV from making copies of itself, or replicating, inside your body. This helps keep the amount of HIV in your body -- called your viral load -- low.

HIV attacks and destroys certain cells of your immune system called T cells. But having a low viral load means fewer T cells get destroyed and gives your immune system a chance to repair itself. One of the main goals of ART is to help reduce, or suppress, your viral load.

There are different ART options, each made up of a combination of medicines. ART is available as pills that you take by mouth every day or as shots given by your healthcare team member every month or longer apart, depending on your treatment plan.

What U = U Means

ART cannot cure HIV. But taking it as directed can help keep your viral load so low that the amount of HIV can't be detected (found) by a test. This is called having an undetectable viral load, or becoming virally suppressed.

Having an undetectable viral load is one of the keys to a healthy life when you're living with HIV. Having an undetectable viral load also means that you essentially have no chance of spreading, or transmitting, HIV to a sexual partner who is negative for HIV. This is known as U = U, or undetectable equals untransmittable.

Why Taking ART as Directed Is Important

Many people who take ART as directed can reach an undetectable viral load within a few months. But some HIV is still present in your body, even when your viral load is suppressed and you're undetectable. So taking ART as directed is key. Because if you skip or miss doses, there won't be enough medicine in your body to stop HIV from replicating.

When this happens, your viral load can increase quickly and your T cells can get destroyed, weakening your immune system. It also means that your viral load may no longer be undetectable, which increases your chances of transmitting HIV to someone else.

Not Taking ART as Directed Can Lead to Drug Resistance

Not taking ART as directed also increases the chances of drug resistance developing. Drug resistance can happen when there's not enough medicine in your body to keep HIV from replicating. And the more chances HIV has to replicate, the more chances it has to mutate (change) into a strain that's resistant to ART.

When HIV becomes drug resistant, the ART being used to treat it -- and similar ART -- no longer works. This limits your options for successful treatment. Drug-resistant HIV can also be transmitted to others.

If You Have Trouble Sticking to Your Treatment Plan 

No matter which ART you're taking, it's important to take it as directed. With pills, you'll need to remember to take them every day. With shots, you'll need to see your healthcare team member regularly. 

If you've missed a dose or can't make an appointment, be sure to tell your doctor or healthcare team member as soon as possible. You can also ask about ways to help prevent transmitting HIV to others until your viral load is confirmed as undetectable.

Also be sure to tell them if you're having trouble taking ART as directed. They can share tips for sticking to your plan and talk about which ART may be a good fit for you and if switching ART may be an option.

Tips for Taking ART as Directed

Tips to help you take ART as directed can include:

  • Set a consistent date for appointments for shots or a time every day to take pills

  • Create a routine and link taking ART with another activity you regularly do. If ART should be taken with food, try linking it to certain meals

  • Use an alarm or reminder app on your phone or watch

  • Track your doses and appointments with a calendar, diary, or log

Robin talks about her experiences with taking ART and tips for sticking to your treatment plan.

Tips for Taking ART as Directed (cont)

Other tips can include:

  • Use a pill box or organizer that you fill weekly or monthly. If you take ART as shots, you can put a reminder note in the box for your appointment day

  • Set up automatic refills at your pharmacy

  • Use the buddy system and have a partner, friend, or family member call, text, or email you

  • Reward yourself with a fun, healthy treat at the end of the week or month for sticking to your treatment plan

Talking to Your Doctor and Healthcare Team About ART

Your health and lifestyle may change over time, which means your treatment plan may change. So seeing your doctor or healthcare team member regularly and talking about ART that meets your individual needs is important. It's also important to know how often you should get your viral load checked to make sure it stays undetectable.

Having open and honest communication will be key. Be sure to tell them if you're sticking to your plan and, if not, what's making it hard for you to do so. Together, you can make a treatment plan that works for you.

Test Your Knowledge

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View Additional Materials on this topic that you may find useful:

HIV Treatment

Let's Stop HIV Together -- HIV Treatment

Taking Your HIV Medicine as Prescribed

Tips for Taking Your HIV Medicine

Positively Aware

Authors and Disclosures

Clinician Reviewer

Karen Badal, MD, MPH

Senior Medical Education Director, Medscape, LLC.

Karen Badal, MD, MPH, has disclosed no relevant financial relationships.


Anita A. Galdieri, PharmD, RPh

Associate Director, Content Development, Medscape, LLC.

Anita A. Galdieri, PharmD, RPh, has no relevant financial relationships.


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