Treatment2023-08-21T17:53:33+03:00

We provide the following services:

  • antiretroviral therapy for the treatment of HIV infection;
  • diagnosis and treatment of opportunistic infections;
  • screening and treatment of depression.

Ancillary services accompanying treatment:

  • “peers” counseling and support;
  • social support;
  • StART club for the formation and maintenance of adherence to ART, adaptation to living with HIV.
HIV infection is not a death sentence. An HIV-positive person or a person with the immunodeficiency virus can lead a normal life and live to a ripe old age if they have access to appropriate therapy and adhere to it.

What should be known about antiretroviral therapy (ART)?

Currently, the most effective method of treating HIV is antiretroviral therapy (ART).

The uniqueness of ART lies in the fact that within six months of taking the appropriate medications, the viral load in the blood of an HIV-positive person significantly decreases. If an HIV-positive person does not take ART, the HIV virus replicates intensively, leading to illness and the potential transmission of HIV to their sexual partner. HIV can also be transmitted from mother to child during pregnancy, childbirth, and breastfeeding. The use of antiretroviral therapy prevents the sexual and mother-to-child transmission of HIV and can also serve as prophylaxis for people living without HIV.

At present, antiretroviral drugs are classified into five main groups:
  • Nucleoside reverse transcriptase inhibitors (NRTIs).
  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs).
  • Protease inhibitors (PIs).
  • Integrase inhibitors (IIs).
  • Fusion inhibitors (FIs).
  • In Ukraine, the first four groups are used in HIV treatment.

How to take antiretroviral therapy (ART)?

ART should be initiated as early as possible, right after a person learns about their HIV status.

To ensure the effectiveness of antiretroviral drugs and stop HIV replication, they must be taken daily as prescribed by the doctor.

If a person with HIV is taking any other form of treatment, they should consult with a doctor regarding possible interactions with antiretroviral medications. This also applies to the use of narcotics. However, this does not mean that ART is contraindicated for people who use drugs or other medications.

Currently, antiretroviral drugs do not cure HIV but only stop its replication. Therefore, it is essential to take them continuously.

The effectiveness of treatment depends on adherence to therapy. People with HIV must take antiretroviral drugs daily, in the correct doses, at the specified times, and following the prescribed guidelines throughout their entire life.

Reduced adherence to ART can lead to a decrease in treatment effectiveness and the development of HIV resistance to the medications. In other words, if a patient does not take the drugs every day and exactly as prescribed by the doctor, the virus may have a chance to change and become insensitive to the medications.

It is important to inform the doctor about anything that hinders the timely and correct intake of medications, as well as any side effects experienced. Side effects are the most common reason for reduced treatment adherence.

Almost all medications have some side effects, although in most cases, they are mild and can be easily managed. Only a small number of side effects may seriously affect well-being and lead to changes in the treatment regimen. Therapy becomes part of the daily routine for most people and easily integrates into their everyday life.

What is HIV?2023-08-21T17:41:50+03:00

HIV infection is a disease that develops as a result of prolonged exposure to the human immunodeficiency virus (HIV) in human immune system cells and is characterized by progressive immune system weakening.

The final stage of HIV infection is acquired immunodeficiency syndrome (AIDS). It manifests through the development of severe opportunistic infections of viral, bacterial, and parasitic nature, the occurrence of neoplasms, and damage to the nervous system, which, without proper treatment, inevitably leads to the patient’s death.

From the moment of HIV infection to several years, a person may not show any symptoms of HIV. HIV-positive individuals may not feel sick, but at the same time, the virus replicates in the body and destroys immunity. The more virus in the blood, the worse the well-being becomes, and the more severe the course and number of opportunistic infections.

How can one contract HIV infection?

Main routes of infection:

  • Parenteral, i.e., through injection.
  • Through blood or other biological fluids such as blood, semen, cervical mucus, and breast milk.
  • Sexual transmission.
  • Vertical transmission – from mother to child during pregnancy, childbirth, and breastfeeding.
What is ART?2023-08-21T17:42:51+03:00

Antiretroviral therapy (ART) is a medication in the form of tablets that stops the replication of the human immunodeficiency virus (HIV).

Combined antiretroviral regimens typically consist of three active drugs from two or more classes.

The initiation of all components of the ART regimen should occur simultaneously. Antiretroviral medications need to be taken daily in the correct doses, at the specified times, and as prescribed by the doctor. It is not recommended to undergo treatment with an incomplete regimen, even for a short period. Most recommended regimens do not involve a large number of tablets and are well tolerated by the body.

Is possible to live a long life with HIV?2023-08-21T17:43:38+03:00

Thanks to antiretroviral therapy (ART), a person who is HIV-positive can lead a normal life and live to a ripe old age. ART has reduced the incidence of illnesses and mortality associated with HIV, transforming HIV infection into a manageable chronic condition.

ART is highly effective in preventing the transmission of HIV. A pregnant woman with HIV, when receiving ART regularly and on time, can give birth to a healthy child.

When should HIV treatment be started?2023-08-21T17:44:13+03:00

Antiretroviral therapy (ART) should be initiated as early as possible, right after a person learns about their HIV status.

ART is recommended for all individuals with HIV in order to reduce the risk of developing opportunistic infections, prevent virus transmission, and decrease HIV-related mortality.  

The commencement of ART is not dependent on the level of immune cells in the body (specifically CD4+ T lymphocytes). Delaying the start of ART until CD4+ T-cell counts decline could increase the risk of developing diseases and complications associated with HIV in HIV-positive individuals. Additionally, the ability to restore CD4+ cell counts in the blood is directly related to the CD4+ count at the beginning of ART therapy.

Is it possible to stop antiretroviral therapy?2023-08-21T17:44:42+03:00

HIV infection cannot be completely cured with existing antiretroviral drugs, but they do suppress the virus’s development. Therefore, interrupting treatment leads to the virus regaining its viability. As a result, the functioning of the immune system deteriorates, and HIV infection progresses. Once treatment is initiated, patients need to continue taking ART throughout their lifetime.

It’s better to take antiretroviral medications with a delay than to miss a dose.

Is it allowed to make a brake in treatment?2023-08-21T17:45:17+03:00

Therapy can be temporarily interrupted if an individual experiences severe adverse reactions to medications or develops associated conditions that prevent oral medication intake due to their individual physiological characteristics.

If an individual needs to undergo certain medical procedures and discontinue antiretroviral therapy (ART) for 1-2 days, this applies to all components of the ART regimen. Treatment should be resumed as soon as possible once the opportunity arises. Temporary interruption of ART (e.g., less than 1-2 days) involves preserving all the medications in the regimen.

Partial non-adherence to the treatment regimen due to “medication fatigue” can result in:

  • Inadequate response of the body to treatment.
  • Increased viral load.
  • Restoration of clinical signs of the disease and progression of HIV infection.
  • Development of drug resistance and loss of future treatment options.
  • Increased risk of HIV transmission.
  • Decreased CD4+ T-cell count.
  • Onset of acute retroviral syndrome.
Is changing the antiretroviral therapy regimen allowed?2023-08-21T17:45:36+03:00

The antiretroviral therapy (ART) regimen can be changed if suppression of the virus cannot be achieved or maintained with the initial regimen. Often, doctors need to switch patients to another regimen that includes at least two active medications.

Before changing the regimen, it is critically important for both the doctor and the patient to thoroughly assess the reason(s) for virological failure: incomplete adherence to the treatment regimen, poor tolerance of medications, or interactions between drugs and food. The doctor should analyze the dynamics of changes in the quantity of HIV genetic material in the person’s body, the count of CD4+ immune system cells, treatment history, and results of drug resistance testing.

Other reasons for changing the ART regimen can include the desire to improve the regimen or the availability of new, more effective medications with better tolerability.

The main principle of regimen substitution is to maintain suppression of viral load.

What is CD4 and viral load?2023-08-21T17:46:19+03:00

The quantity of HIV RNA and CD4+ T-lymphocytes are two main indicators of the body’s response to antiretroviral therapy (ART) and the progression of HIV infection.

HIV RNA represents the genetic material of the human immunodeficiency virus, forming the viral load in the body. Viral load measures the amount of virus in a drop of blood.

CD4+ lymphocytes are T-cells of the immune system, the count of which provides general information about the individual’s immune system status.

Monitoring viral load after initiating ART provides clinical benefits. Calculating CD4+ cell counts is also used to understand if ART is effective. However, viral load provides more precise information.

Determining the count of CD4+ T-lymphocytes is useful before initiating ART. This indicator is crucial for establishing the criteria for starting and discontinuing opportunistic infection prophylaxis.

Since ART is now recommended for all HIV-positive patients, regardless of viral load or CD4+ count, determining CD4+ and viral load levels before starting ART is not mandatory.

For patients with consistently suppressed viral load and immune system restoration due to ART, the CD4+ count indicator is less informative.

If antiretroviral drugs and the treatment regimen are effective, the viral load reaches an undetectable level (HIV RNA <40 copies/mL) after 6 months of ART initiation.

Viral load assessment is conducted 6 months after starting ART and every 6 months during the first 2 years of treatment for patients with stable viral suppression.

CD4+ T-lymphocyte count analysis is recommended every 3-6 months if CD4+ cell count is <300 cells per microliter and in the presence of virological treatment failure. For patients on ART for more than 2 years, with consistent viral suppression, and immune system restoration (CD4+ count >500 cells per microliter), determining CD4+ count is not mandatory.

Is it true that antiretroviral therapy has many side effects?2023-08-21T17:46:41+03:00

The benefits of suppressing viral load and improving immune response far outweigh the risks associated with the side effects of some antiretroviral drugs.

At the beginning of ART use, side effects were among the most common reasons for changing or discontinuing therapy and for non-compliance with the medication regimen. New antiretroviral regimens have fewer serious side effects than those used in the past.

Less than 10% of patients taking ART experience side effects that limit treatment. Replacing an effective antiretroviral regimen (drug) with a new regimen (or drug) should be done correctly and only when the potential benefits of the change outweigh the potential complications from switching treatment. The fundamental principle of changing a regimen is to maintain suppression of viral load.

The use of modern standardized ART regimens allows the doctor and patient to be prepared for typical side effects caused by antiretroviral drugs and their combinations. It also allows for predicting possible interactions with other medications that the patient may take for the prevention and treatment of co-occurring illnesses.

What to do if hiv is detected during pregnancy?2023-08-21T17:47:04+03:00

Previously, HIV-positive women were often recommended to undergo abortion during pregnancy. Nowadays, completely eliminating the risk of HIV transmission from mother to child is not possible, but it can be minimized. The presence of HIV infection in a pregnant woman is not a reason for terminating the pregnancy.

Without specific prevention measures during pregnancy and childbirth, HIV can be transmitted in 30-40% of cases. Prevention measures can reduce the risk of mother-to-child HIV transmission to as low as 1%.

Vertical transmission of HIV from mother to child can occur during pregnancy, childbirth, and breastfeeding for babies born to HIV-positive mothers.

To reduce the risk of mother-to-child HIV transmission, women are prescribed antiretroviral therapy (ART), cesarean section is performed based on obstetric indications, and breastfeeding is discouraged.

ART is considered standard care for HIV-positive pregnant women, both for treating HIV infection and preventing mother-to-child transmission. ART is recommended for all HIV-positive pregnant women, regardless of virological, immunological, or clinical indicators. After childbirth, ART should be continued throughout life. Since ART in the mother reduces but does not eliminate the risk of HIV transmission, breastfeeding should be avoided.

Who and why should take pre-exposure prophylaxis (prep)?2023-08-21T17:47:26+03:00

Pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs with the aim of reducing the likelihood of HIV infection in individuals with a negative HIV status in cases of high risk of HIV transmission.

PrEP may be prescribed to individuals engaged in risky sexual or injection behaviors (men who have sex with men; men and women at high risk of HIV infection through heterosexual contact; commercial sex workers; people who inject drugs) and to HIV-negative partners in HIV-discordant couples (where one partner is HIV-positive), especially if the HIV-positive partner is not on antiretroviral therapy (ART) or viral suppression hasn’t been achieved on ART, as well as when planning pregnancy.

Before prescribing PrEP, it is essential to undergo HIV testing and exclude symptoms of acute HIV infection, undergo testing for viral hepatitis and kidney diseases.

Who is recommended to take post-exposure prophylaxis (PEP)2023-08-21T17:47:59+03:00

Post-exposure prophylaxis (PEP) is a short-term course of antiretroviral treatment aimed at reducing the likelihood of HIV infection in individuals who have been exposed to an increased risk of such infection.

Healthcare workers have been prescribed ART for post-exposure prophylaxis following professional contact with HIV since the early 1990s. Over the past two decades, post-exposure prophylaxis for HIV infection has also been prescribed to individuals who have had unprotected sexual contacts.

PEP should be initiated as soon as possible after a potential HIV exposure incident, but no later than 72 hours after the contact. A 28-day course of ART is prescribed for the purpose of post-exposure prophylaxis.

Can I choose a clinic for medical monitoring on my own?2023-08-21T17:48:18+03:00

Every patient has the right to independently choose a healthcare facility for medical monitoring related to HIV. This can be an AIDS Center, a “Dovira” office, a “Test & Treat” clinic, or any other suitable institution. The only requirement is to select a facility where you will feel most comfortable receiving medical, social, and psychological support.

If I’m not a patient of your clinic, can I receive services?2023-08-21T17:48:46+03:00

At the “Test & Treat” clinic, assistance is provided to HIV-positive individuals who are clients of the clinic and are under medical supervision. In order to become a client of the clinic, an HIV-positive person needs to visit the clinic with their passport and a medical record from a hospital where they were previously receiving HIV-related care. If HIV is detected during testing at the “Test & Treat” clinic, you can become a patient immediately.

All others can receive free HIV testing services.

What is the difference of the “Test & Treat” clinic from other clinics?2023-08-21T17:49:15+03:00
  • Patient-friendly approach in a comfortable environment.
  • Rapid HIV testing with the possibility of receiving medical supervision on the day of receiving a positive result, enabling a swift start of treatment.
  • Access to consultations based on the principle of equality.
  • Provision of comprehensive integrated services at convenient times (extended working hours, Saturday services).
  • Free services, including high-tech diagnostic methods.
  • Availability of additional services: mental health support, diagnosis, prevention, and treatment of associated infections, conditions, and diseases; cancer screening for women; reproductive health counseling.
  • Counseling and management of HIV-negative partners in HIV-discordant couples (where one partner is HIV-positive).
What services are provided for free at the “Test & Treat” clinic?2023-08-21T17:49:45+03:00

The “Test & Treat” clinic offers only quality services exclusively on a free basis.

Testing and Prevention:

  • HIV testing and prevention;
  • Distribution of condoms;
  • Screening for syphilis and viral hepatitis;
  • Post-exposure prophylaxis for HIV;
  • Prevention of opportunistic (associated) infections;
  • Cancer screening for women;
  • Reproductive health counseling.

Treatment:

  • HIV treatment (antiretroviral therapy, monitoring treatment effectiveness);
  • Diagnosis and treatment of opportunistic infections;
  • Diagnosis and treatment of associated diseases and conditions (diabetes, cardiovascular diseases, bone diseases, etc.);
  • Mental health support services.

Psychosocial Support:

Counseling on living with HIV infection and treatment options;

Psychosocial support for people with HIV and their families.

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