How do I find the right doctor?
One of the most important tools that you have is your relationship with your doctor. It's important to know that fighting HIV is more complicated than treating a cold. HIV disease is not the same in all people.
Finding a doctor who has experience treating people living with HIV is very important. Studies have shown that people with HIV who see doctors experienced in treating people with HIV are more likely to be long-term survivors than those with inexperienced doctors.
According to these studies, an HIV-experienced doctor is someone who has five or more people in their practice who are living with HIV, though in general, the more experience and patients the physician has, the better. Consider five a minimum. Experienced doctors will usually have more skill in prescribing and monitoring effective medications, and are also more likely to wisely prescribe preventative therapies. Because women face unique gynecological and pregnancy concerns, choosing an experienced gynecologist and/or obstetrician is also important.
In some cases, choosing a highly HIV-experienced doctor is not possible. This is especially true in rural settings where HIV positive persons may be more isolated than in major cities. This does not mean that one needs to receive less than optimal care.
Even in the most rural settings, there is usually at least one healthcare provider who has worked with HIV positive persons. Some experience is better than none. However, it may mean that the patient and doctor need to be more diligent in learning about HIV, keeping up to date on the latest in treatment information, and finding appropriate resources.
Developing an open and comfortable relationship will help this ongoing process. Often, in such situations, people living with HIV play an important role in keeping their doctors up to date by bringing them new information, reports from medical conferences, and resources available from groups like Project Inform. While physicians may sometimes at first be inclined to reject information from anyone other than doctors, they often overcome this prejudice when they realize that, at least in HIV disease, community groups often have better access to information and more time to review it than they do. Many physicians come to welcome the input their patients can bring them.
Finally, the general principle of choosing an HIV-experienced doctor applies to practitioners of alternative systems of healing, such as traditional Chinese medicine practitioners, herbalists, acupuncturists, and other holistic healers. If you have an interest in complementary or alternative therapies, the healthcare provider should have experience in their use with HIV-positive people, not just experience with therapies themselves.
Some herbs and supplements, for example, can affect the way commonly used medications to treat HIV are absorbed in the body, so knowledge of both types of therapy is critical. A doctor or healing practitioner who keeps up-to-date on literature about new discoveries in our understanding of HIV disease and who has experience treating people living with HIV is an important partner in your healthcare.
When choosing a doctor, interview potential providers and discuss their experience with HIV. If they are not willing to do this, that is a good sign you will not be able to have an open and collaborative relationship with them and you should look for another provider.
Contacting the AIDS/Infoline at 1-800-99-AIDS-9 (1-800-992-4379) or (504) 821-6050 can be a good place to start putting together a list of possible providers. If you have insurance, your choice of providers might be limited but it does not mean that you can't research who would be your best choice. Other HIV positive persons can also be a great source of information about individual providers.
Drugs to treat HIV can improve quality of life and help HIV positive people stay healthier longer. But starting treatment is a big decision. In order to get the maximum benefit from the drugs, you need to make a commitment to taking them correctly. Commitment to the treatment is as important as the drugs themselves. So before you get started, make sure that you are ready to stick to it for the long haul! This takes a combination of finding the right doctor, increasing your knowledge about HIV, and maintaining the right attitude.
Scientists have developed drugs that block HIV from reproducing (multiplying) at different stages of its life cycle. There are four classes of drugs:
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Fusion inhibitors
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Nucleoside/nucleotide reverse transcriptase inhibitors ("nukes" or NRTIs)
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Non-nucleoside reverse transcriptase inhibitors ("non-nukes" or NNRTIs)
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Protease inhibitors (PIs)
These drugs are always used in combinations known as HAART. HAART stands for Highly Active AntiRetroviral Therapy. HAART attacks HIV at different points using different drugs (usually from different classes). This is the best way to reduce the amount of HIV (viral load) in your blood.
Going on HIV treatment for the first time can seem scary and overwhelming. There is no right or wrong answer. Working closely with your doctor, you can determine the best time to start.
