http://www.who.

int/hiv/strategy2016-2021/online-consultation/en/

Defining 2016-2021 Global Health Sector Strategies for

HIV / Viral Hepatitis / Sexually Transmitted Infections
Online consultation
As the world looks to 2030, and prepares to meet the challenges of an ambitious set of
Sustainable Development Goals, the World Health Organization is developing three global health
sector strategies to cover:

HIV/AIDS;

viral hepatitis; and

sexually transmitted infections (STIs).

The strategies will cover 2016-2021 and will be finalized for consideration by the 69th World
Health Assembly in 2016. We are now seeking input into the strategies.
From this web page you can access an online survey for each of the proposed strategies as well
as useful background documents including early draft outlines of the three strategies. The
deadline for responses is 8 May 2015. Survey results will be compiled into a report to be
published in June 2015. Your responses may be posted on the WHO web site as part of this
process unless you indicate at the end of the survey that you prefer to remain anonymous.
Responses from individuals, organizations and/or consolidated responses are welcome.

Access online survey

Background

The Global health sector strategy on HIV/AIDS, 2011-2015, endorsed by the

World Health Assembly in 2011 (resolution WHA64.14), will end in 2015.
Strategy progress was discussed at WHA67 in May 2014. During these
discussions several Member States requested the WHO Secretariat start a
process to develop a post-2015 HIV strategy.

In 2006, the WHA approved the Global strategy for the prevention and
control of sexually transmitted infections: 2006-2015 (resolution WHA59.19).
The final progress report on implementation of the strategy will be presented
to the WHA in 2015.

Since 2012 WHO's Global Hepatitis Programme has been guided by the
Prevention and Control of Viral Hepatitis Infection: Framework for Global
Action. A resolution on hepatitis (WHA67.6) was adopted by the WHA in May
2014, calling for an intensified and expanded global hepatitis response and

for the WHO Secretariat to examine the feasibility of elimination of hepatitis B

and C.

Structure and approach

We propose that the three strategies are organized around a similar structure to include the
following sections:

Context and Rationale: Making the Case for Action

Vision, goals and targets in conjunction with the United Nations sustainable
development goals and disease-specific targets

Four strategic directions:

o

Essential Quality Services and Interventions

Achieving Impact and Equity: Populations and Locations

Innovation for Acceleration

Finance for Sustainability

Securing an Enabling Environment

Strategy Implementation

Key dates in the strategy development timeline

MarchApril 2015: Public online consultation

AprilMay 2015: Regional consultations

May 2015: Consultations with Civil Society Reference Group

May 2015: Briefings at the 68th World Health Assembly

SeptemberOctober 2015: Review of draft strategy at WHO regional

committees

October 2015: Briefing for development partners

November 2015: Briefing for missions/Member States

January 2016: 137th session of the WHO Executive Board

May 2016: Consideration of the strategy at the 69th World Health Assembly

http://www.thebody.com/content/art14499.html

STDs and HIV

Community Forum Summary

By Anne Monroe
From AIDS Community Research Initiative of America
October 2000
A note from TheBody.com: The field of medicine is constantly evolving. As a result, parts of this article
may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent
information!

Speakers: Thomas Cherneskie, M.D., M.P.H.

James Brown, New York City Department of Health STD Control Program
It can be hard to get people to talk frankly about sex, let alone to talk about sexually transmitted
diseases (STDs) -- not exactly dinnertime conversation. But for Dr. Thomas Cherneskie and James
Brown, talking about STDs is the first step in preventing the more than 50 diseases and conditions
associated with the more than 26 infectious organisms spread through sexual contact, some of which
(including HIV, syphilis, and hepatitis) can be fatal. At the October 2000 community forum, the two
men discussed the links between HIV and other STDs and offered tips for preventing, recognizing, and
treating STDs.
HIV and other STDs have a strong interplay. Among men reporting sex with other men who were
diagnosed with gonorrhea or syphilis at one of the NYC Department of Health STD Clinics in 1999,
thirty-two percent were also HIV-positive. Herpes, a viral infection that causes lesions (including open
sores or small breaks in the skin) often around the genitals is also of concern in HIV transmission.
Having an STD makes it easier both for HIV-negative men and women to get infected with HIV and for
HIV-positive persons to infect their partners. Why? Well, there are a couple of reasons. First, open

sores in the genital area resulting from STDs decrease the skin's ability to act as a barrier to infection
and allows HIV easy access to the body. Second, inflammation at the site of an STD (including
gonorrhea and chlamydia) results in a flood of inflammatory blood cells traveling to that area. This
leads to a high concentration of CD4 cells at the site of infection, serving as easy targets for HIV.
Finally, in the case of herpes, proteins that the herpes virus uses to copy itself can "rev up" HIV
reproduction thus increasing the HIV viral load at the site of a herpes ulcer. A person's susceptibility to
HIV infection seems to be increased 2-5 fold by an ulcer-causing STD or inflammatory STDs like
gonorrhea and chlamydia.
Dr. Cherneskie described some of the health problems caused by STDs, which can be even more
serious in people who are HIV-infected. Left untreated, syphilis can cause severe brain or heart
disease. Syphilis hits harder in people with HIV, more often leading to neurosyphilis (syphilis in the
nervous system) in HIV-positive people than in HIV-negative people. Although most Human
papillomavirus (HPV) infections are either silent or cause benign genital warts, infections with certain
strains of HPV increase a person's risk of developing cancer of the cervix or anus. People with HIV are
more likely to develop cancer than their HIV-negative counterparts if they are infected with HPV.
Women who have STDs such as gonorrhea or chlamydia may develop Pelvic Inflammatory Disease
(PID) if the infection spreads into the upper reproductive tract. PID can lead to infertility, ectopic
pregnancy (a pregnancy in which the fetus develops in the Fallopian tubes instead of in the uterus), or
chronic pelvic pain. The rates of PID are higher in HIV-positive women than in HIV-negative women,
and HIV-positive women are more likely to develop abscesses and require surgery to control the
infection. A number of STDs can be easily treated, but effective treatment only occurs if STDs are
caught early are treated before serious damage occurs.
The NYC Department of Health STD control program aims to decrease the rates of STDs in the
community. Dr. Cherneskie described the techniques used by the Department of Health (DOH) to
pursue that goal: primary prevention, early detection, recognition/evaluation of symptoms, and post
exposure prophylaxis (PEP) against STDs.
In primary prevention, DOH officials emphasize consistent condom/dental dam use in sexual
intercourse (including oro-anal and oro-genital contact). Dr. Cherneskie noted that vaccinations
against hepatitis A and B (viral infections that damage the liver) are also useful in disease prevention,
especially in persons with HIV.
It is important to note that although effective treatment exists for many of the bacterial STDs (e.g.
gonorrhea, chlamydia, and syphilis), we are left without a cure for many others including herpes,
genital wart virus, hepatitis and HIV; therefore primary prevention is the only effective means of
remaining healthy.
Because STDs don't always have symptoms, STD screening tests should be performed regularly. These
screening tests are crucial to early detection of STDs, the second component of the Department of
Health's program. Screening tests should be performed at the time of HIV diagnosis and periodically
thereafter depending on risk. Screening tests are often performed for women during regular
gynecological examinations. Women should have cervical Pap smears (collection of cervical cells to
check for early cancer) at least once a year, irrespective of HIV-status; both HIV-infected men and
women may want to consider having anal pap smears as well to detect early cancer changes in this
area.
When there are symptoms of STDs, recognizing them may lead to earlier access to treatment and
prevention of long-term damage. Let's review some of the biggies.

First is syphilis, caused by Treponema pallidum, a kind of bacteria. Syphilis occurs in four
stages. In the first stage, an open sore called a chancre forms. It doesn't hurt, and it goes away

after a couple of weeks even without treatment. A chancre can occur anywhere on the body. It
appears at the first place that contact with syphilis occurred. Even after the chancre heals,
syphilis stays in the body. About four months after becoming infected with syphilis, a skin rash
all over the body may develop, often including the palms of hands and soles of the feet and
usually accompanied by flu-like symptoms and swollen glands. Other signs of secondary syphilis
include spots on the tongue and moist warty bumps on the genitals. Syphilis can then enter a
silent period for decades when the only way to detect it is by blood test. In its final stage,
syphilis can eat away at skin, bones and other organs throughout the body. Most people found
to be infected with syphilis do not report any symptoms at all and therefore asymptomatic
screening by blood testing is the only way to detect the infection before severe brain, bone, or
heart damage can occur.

Chlamydia is caused by a bacterium called Chlamydia trachomatis. In most cases there are
often no visible signs of chlamydia infection. In men, there may be clear discharge from the
urethra (penis) or burning with urination; in women, symptoms include abnormal vaginal
discharge or bleeding, pain with sex, burning with urination, or lower belly pain. An infection
can last for months, or longer, if not treated, but can still cause damage even when silent.

Men who have gonorrhea may have a pus-like yellow discharge from the urethra, or pain
when they urinate. The majority of women don't have symptoms of gonorrhea. If they do have
symptoms, they are similar to those of chlamydia.

Infection with a Human Papilloma Virus (HPV) can cause genital warts. These warts are either
bumpy like cauliflower or small flat growths. They don't hurt, and they can be big or small.
Some strains of HPV can cause cervical cancer.
The final element of optimal STD care and prevention is post-exposure prophylaxis (PEP). Through
PEP, health department workers and private clinicians hope to interrupt incubating disease before it
has serious ill effects by treating early stages of STDs.
James Brown, the second speaker, described his work with the Department of Health STD control
program. He began by listing the STDs that are reportable to the Department of Health: syphilis,
gonorrhea, chlamydia, non-gonorrhea urethritis, and other rarer STDs (Chancroid, Lymphogranuloma
Venereum, and Donovanosis). It is the responsibility of testing laboratories and clinical providers
diagnosing these STDs to report all new infections to the DOH. The DOH, in turn, tries to interrupt the
chain of further infection in several ways. First, the DOH educates infected individuals about STD
transmission to prevent them from being re-infected. Next, the DOH uses partner notification to
prevent spread of the STD. In partner notification, the DOH offers assistance to patients with an STD
in informing their partners that they have been exposed to an STD and encourages them to seek
treatment (Post-exposure Prophylaxis) so that they can avoid passing the disease to others. Mr. Brown
stressed that participating in partner notification is totally voluntary, and that notification is
anonymous. The exposed individual will only learn that they have been exposed to an STD, not when
the exposure happened or who exposed them.
Mr. Brown and his colleagues do extensive work in STD case management, helping infected individuals
to treatment and prevention services. DOH officials also perform field follow up, heading out into the
community to locate infected individuals and their exposed partners to refer them for their STD care.
Their efforts have contributed to the relatively low rate of syphilis in NYC. Nevertheless, given recent
outbreaks of syphilis in multiple U.S. cities within the past year (LA and Seattle), the city encourages
both patients and health care providers to remain vigilant in attempting to diagnose, treat, and
prevent as many infections as possible. Mr. Brown noted that 91% of New York City's new syphilis
cases are in men, most of whom have other issues, such as substandard housing and poor access to
healthcare, that must be addressed in order for STD treatment to be successful. He also noted that
chlamydia is most prevalent among adolescents, and that teen-specific education efforts are
necessary.

Through their work, Dr. Cherneskie and Mr. Brown are helping to end the silence around STDs and
optimize patient care in the diagnosis, treatment and prevention of these serious infections. Advances
in medicine have facilitated the treatment and prevention of many STDs -- now it will take education
to ensure that these resources are used.

http://www.thebody.com/content/art2283.html

The HIV-STD Connection

Rick Sowadsky
From Rick Sowadsky, M.S.P.H.
March 2009

Years ago, many people considered HIV and other sexually transmitted diseases (STDs) as totally
separate issues (some people still think so today). As you will see, these issues really are interrelated
with one another, and can no longer be looked at as separate issues. Let me review with you some
major points as to why HIV and other STDs are so closely linked.
Point #1: If you have an STD, this strongly indicates that you may have put yourself at risk for HIV
as well. Likewise, if you have HIV, this strongly indicates that you may have put yourself at risk for
other STDs. HIV is transmitted in similar ways to other STDs. Therefore, if a person became infected
with HIV, hepatitis B, gonorrhea, etc., through sexual contact, this means that they were not
adequately practicing safer sex. This could either be due to not using a condom, or having a condom
break or fall off (usually due to incorrect use). Remember, if you have one STD, there is a strong
possibility that you may have other STDs at the same time. Therefore, people with HIV should be
tested for other STDs, and people with other STDs should be tested for HIV.
Point #2: If you have certain STDs, you become at greater risk for acquiring HIV. This can happen
two ways. First, diseases like herpes and syphilis (and others) can cause open lesions that can allow
HIV to gain easier access to the bloodstream. Therefore, when symptoms of these infections are
present, a person is more likely to get HIV, than if they did not have those STDs. In addition,
becoming infected with diseases such as chlamydia and gonorrhea can also increase your risk of
getting HIV. This is because these infections can cause CD4 cells to go to the infected area (like in the
urethra, where you urinate from) in an attempt to fight off the infection. When HIV is also present,
those CD4 cells are prime targets for HIV infection. Once those cells become infected, the HIV
infection is established throughout the body.
Point #3: If you already have HIV, and you get another STD like gonorrhea or chlamydia, you are
more infectious to others! Studies have shown that in men with gonorrhea and non-gonococcal

urethritis (most commonly due to chlamydia), the HIV viral load in semen increases. This is especially
true with HIV-positive men co-infected with gonorrhea. In other words, when an HIV-positive man has
these infections, he is more infectious to others, as far as HIV is concerned. When the infections are
treated with antibiotics, the viral load in semen decreases once again. Antibiotic treatment does not
affect the viral load in the blood. This really should come as no surprise, since infections like
gonorrhea and chlamydia cause CD4 cells to enter the infected area, as a part of the immune system's
attack against these infections. So, if a person has gonorrhea or chlamydia in the urethra, the HIV
viral load in semen increases while the infections persist.
Point #4: If you already have HIV, and you get another STD like herpes, syphilis or genital warts,
those STDs can be more severe than what is normally seen. This should come as no surprise, since
the immune system is a key element in surpressing the symptoms of various STDs. The immune
system may not be able to cure various STDs, but it often does a good job at keeping the symptoms
less severe. If a person's immune system is damaged, those STDs basically go uncontrolled, and the
symptoms can be much more severe than what is normally seen.
As a new way to reduce the further transmission of HIV, we are now starting to push STD prevention
even more, especially as it relates to diseases like gonorrhea. This is in addition to traditional
approaches at controlling the spread of HIV (condoms, etc.). Therefore, reducing the prevalence of
various STDs can indirectly control the further spread of HIV. In addition, preventing STD transmission
can prevent complications in people co-infected with HIV and other STDs.
The time has come to incorporate HIV and other STDs as a single entity. In fact, because of this very
issue, the Centers for Disease Control (CDC) has combined HIV, STDs and TB, into a single
department. It's time for everyone to follow their lead.

ini fresh, wacana untuk penggabungan obat profilaksis

HIV dengan kontrasepsi.
Lessons learnt from the history of contraception are
relevant for the implementation of PrEP
Roger Pebody
Published: 06 January 2016
Jump to

The introduction of the pill

Method mix and health services

Conclusion

References

Achieving a widespread and appropriate use of pre-exposure prophylaxis (PrEP) will take
several years and will require considerable attention to the shape and quality of health services,
according to researchers who have looked at the way in which contraceptive methods have been
introduced.

With five decades of experience with development and implementation, contraception has a lot
to offer the PrEP field in terms of lessons learned for new method introduction, Sinead DelanyMoretlwe and colleagues write in the January issue of Current Opinion in HIV& AIDS. A
narrow focus on promotion of a new technology alone will not increase choice; service delivery
systems and providers are equally important to the success of PrEP introduction.

The introduction of the pill

This is not the first time that the history of contraception has been reviewed in order to identify
parallels with PrEP. Writing three years ago in Clinical Infectious Diseases, Julie Myers and
Kent Sepkowitz noted that American controversies about the oral contraceptive pill are similar to
those surrounding the introduction of PrEP.
Prior to its introduction in the United States in 1960, many doubted that large numbers of women
would want to take a medication in order to prevent pregnancy and pharmaceutical companies
did not believe the market had much potential. Scale-up was slowed by its high initial cost,
equivalent to around $80 a month in todays prices. This, together with a need for regular clinic
visits, created economic and logistical hurdles that only more socially privileged women could
overcome, say Myers and Sepkowitz.
After some years, subsidised programmes and government funding helped to narrow inequalities
in access. Moreover media coverage, word of mouth endorsement and promotion by
pharmaceutical companies led to a swell of interest and acceptance. Women actively sought out
the pill from their doctors.
Similarly, the high cost of PrEP makes it controversial with some, publicly funded PrEP
programmes are only available in a few areas, and there is a risk that its use may exacerbate
health disparities by only protecting those able to afford it. Since the article was published,
awareness of PrEP has grown considerably in gay communities.
As with PrEP, there was concern about the potential side-effects of the contraceptive pill, as
medications taken by healthy people are expected to be safer than those used to treat an illness.
While the contraceptive pills short-term side-effects were understood, its long-term safety
profile was initially unclear. Evidence of a raised risk of deep vein thrombosis only emerged
after a few years and resulted in necessary changes in the way the pill was prescribed.
The authors note that, as with initial contraceptive research, most participants in PrEP studies
were located outside of the US. While safety seems promising for emtricitabine-tenofovir, we
should expect some surprises as use is scaled up to populations who were not included in the
clinical trials, they argue.
Most famously, the contraceptive pill was thought by some to promote promiscuity and to have
caused a sexual revolution in the 1960s and 1970s. Similarly, some predict that PrEP will result
in reductions in condom use and increases in sexually transmitted infections.

However the authors suggest that both claims ignore gradual, ongoing changes in sexual norms
that had begun before the new medical technologies were introduced. Changes in behavior
should not automatically be blamed on the new HIV prevention pill, they say.

Method mix and health services

The more recent article, published by Sinead Delany-Moretlwe and colleagues in Current
Opinion in HIV& AIDS, draws on some of the more recent history, especially in lower and
middle income countries.
They note that increasing choice by introducing new contraceptive products has been seen as key
to increasing the use of contraception. In places where a wide range of delivery systems are
available, both short-acting (e.g. pills and diaphragms) and long-acting (e.g. implants and
injections), usage tends to be higher.
This suggests that adding PrEP to the range of HIV prevention options that are already available
will increase the number of people who are protected in some way from HIV. Moreover, the
option of non-daily dosing of PrEP, and the possible future development of PrEP as a long-acting
injection or a vaginal ring, would increase usage.
Despite such innovations, adherence may remain imperfect. Even among women using
contraceptive injections, discontinuation rates are high, users often switch between methods and
are frequently late for their next injection. In some cases, this is due to failings in health services.
For example services may be difficult or costly to access, or staff may not have warned users
about the potential for side-effects.
Delany-Moretlwe warns that if health services are unable or unwilling to deliver new health
technologies with good quality care then the potential of the new products may not be realised.
Too often, the focus on product development leads to a focus on a single technology, and not on
investing in the larger programmatic and policy initiatives that are essential to product uptake
and use, she says.
The first-generation of oral PrEP products have complex requirements, including monitoring for
side-effects and drug resistance. While this may suggest delivery by providers with experience of
antiretrovirals, they may not reach those needing PrEP.
The channels through which products reach users are important for ensuring access, the
authors say. Programmes which attempt to integrate PrEP into existing HIV prevention
programmes or health services such as reproductive health services for women will need to
be carefully evaluated. The experience with contraception shows that institutional changes to
health services are difficult to achieve and to maintain, for example when the results from pilot
projects are transferred to larger settings.

In contraception, medical barriers to access have been removed as increasing evidence of safety
has emerged. Products may be available over the counter or through community-based
distribution agents. Although this expanded access has occasionally been at the cost of lowerquality provision and monitoring, similar efforts will need to be made for PrEP. All possible
mechanisms for providing access to PrEP will need to be explored to ensure that PrEP is
accessible to those with the greatest need, Delany-Moretlwe argues.
Both contraception and PrEP draw attention to the broader social, economic, and political
context in which sexual relationships occur. Although they both have the potential to be
empowering technologies, uptake may be limited where gender inequalities are strong.
Adolescents may be prevented from accessing contraception by official policies or due to
healthcare providers personal views about young peoples sexual activity. Marginalised key
populations such as sex workers and men who have sex with men may have particular barriers
to accessing health services.
But the authors say that if PrEP is primarily offered to specific groups, such as sex workers, then
this risks undermining wider acceptance of the product. This has sometimes occurred with
female condoms, but has in other countries been avoided by providing female condoms in family
planning clinics. If PrEP is to be successfully introduced, the needs and views of all users will
need to be carefully considered.
The authors warn against expectations that PrEP will be an overnight success. Several different
contraceptive methods have taken decades to be widely used, showing that slow initial uptake of
a product should not be interpreted as a fundamental problem with acceptability. Products which
require different practices from users, communities or healthcare providers may take some time
to get off the ground.

Conclusion
PrEP advocates can learn many lessons from contraception, Sinead Delany-Moretlwe argues.
Perhaps the most important of these is that a narrow focus on a single technology alone is
unlikely to solve health and social challenges associated with HIV. That, however, is no cause for
inaction, but rather a call for innovation to expand the HIV prevention mix, to pay careful
attention to access and service delivery issues and constraints, and to incorporate the views and
perspectives of all stakeholders.

References
Myers JE & Sepkowitz KA. A Pill for HIV Prevention: Dj Vu All Over Again? Clinical
Infectious Diseases 56: 1604-1612, 2013.
Delany-Moretlwe S et al. Planning for HIV preexposure prophylaxis introduction: lessons
learned from contraception. Current Opinion in HIV & AIDS 11: 8793, 2016.

Sumber : https://www.aidsmap.com/Lessons-learnt-from-the-history-of-contraception-arerelevant-for-the-implementation-of-PrEP/page/3025233/

TERAPI HIV
HOW IS HIV TREATED?
HIV is treated using a combination of medicines to fight HIV infection. This is called
antiretroviral therapy (ART). ART isnt a cure, but it can control the virus so that you can
live a longer, healthier life and reduce the risk of transmitting HIV to others.
ART involves taking a combination of HIV medicines (called an HIV regimen) every day,
exactly as prescribed.
These HIV medicines prevent HIV from multiplying (making copies of itself), which
reduces the amount of HIV in your body. Having less HIV in your body gives your

immune system a chance to recover and fight off infections and cancers. Even though
there is still some HIV in the body, the immune system is strong enough to fight off
infections and cancers.
By reducing the amount of HIV in your body, HIV medicines also reduce the risk of
transmitting the virus to others.
ART is recommended for all people with HIV, regardless of how long theyve had the
virus or how healthy they are. If left untreated, HIV will attack the immune system and
eventually progress to AIDS.

HIV DRUG CLASSES

HIV medicines are grouped into six drug classes according to how they fight HIV. The
six drug classes are:

Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

Nucleoside reverse transcriptase inhibitors (NRTIs)

Protease inhibitors (PIs)

Fusion inhibitors

CCR5 antagonists (CCR5s) (also called entry inhibitors)

Integrase strand transfer inhibitors (INSTIs)

The six drug classes include more than 25 HIV medicines that are approved to treat HIV
infection. Some HIV medicines are available in combination (in other words, two or more
different HIV medicines are combined in one pill.)
The U.S. Department of Health and Human Services (HHS) provides guidelines on the
use of HIV medicines to treat HIV infection. The HHS guidelines recommend starting
ART with a regimen of three HIV medicines from at least two different drug classes.
NIH AIDSInfos FDA-Approved Medicines provides a complete list of HIV medicines,
grouped by class, that are approved by the U.S. Food and Drug Administration (FDA) for
the treatment of HIV infection in the United States. In addition, NIAIDs Drugs that Fight
HIV (PDF 1.3MB) is a full-color illustrated guide to approved HIV medications.

CHOOSING AN HIV REGIMEN

The choice of HIV medicines to include in an HIV regimen depends on a persons
individual needs. When choosing an HIV regimen, people with HIV and their health care
providers consider the following factors:

Other diseases or conditions that the person with HIV may have

Possible side effects of HIV medicines

Potential interactions between HIV medicines or between HIV medicines and other medicines the person
with HIV is taking

Results of drug-resistance testing (and other tests). Drug-resistance testing identifies which, if any, HIV
medicines wont be effective against a persons HIV.

Convenience of the regimen. For example, a regimen that includes two or more HIV medicines combined in
one pill is convenient to follow.

Any issues that can make it difficult to follow an HIV regimen, such as a busy schedule that changes from
day to day

Cost of HIV medicines

There are several recommended HIV regimens, but selecting the best regimen for a
particular person depends on the factors listed above.
If you are starting HIV treatment for the first time, NIH AIDSInfo shares information
about selecting a first HIV regimen.

Treatment Options
First Steps to TreatmentOverview of HIV TreatmentsReasons to Start TreatmentSide EffectsMedication
AdherenceDrug ResistanceChanging or Stopping TreatmentClinical TrialsAlternative Therapy

RELATED TOPICS ON AIDS.GOV

HIV Lifecycle

Newly Diagnosed: What You Need to Know

Resistance Test

Treatment Adherence

ADDITIONAL RESOURCES

AIDSinfo - Clinical Guidelines Portal

AIDSInfo HIV Treatment: The Basics

AIDSInfo What to Start: Selecting a First HIV Regimen

AIDSInfo FDA-Approved HIV Medicines

CDC Every Dose. Every Day. Medication Adherence Consumer Handouts

CDC HIV Treatment Works Campaign

FDA Antiviral Drugs Used in the Treatment of HIV Infection

FDA HIV and AIDS: Medicines to Help You

NIAID - Drugs That Fight HIV

OWH - Managing Your Treatment of HIV/AIDS

VA: Treatment Decisions

VA: Questions to Ask Your Doctor About HIV Drugs

Sumber https://www.aids.gov/hiv-aids-basics/just-diagnosed-with-hiv-aids/treatmentoptions/overview-of-hiv-treatments/

Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)

Synonym(s): Non-Nucleoside Analogue Reverse Transcriptase Inhibitor
Antiretroviral (ARV) HIV drug class. Non-nucleoside reverse transcriptase inhibitors
(NNRTIs) bind to and block HIV reverse transcriptase (an HIV enzyme). HIV uses reverse
transcriptase to convert its RNA into DNA (reverse transcription). Blocking reverse
transcriptase and reverse transcription prevents HIV from replicating.

Nucleoside Reverse Transcriptase Inhibitor (NRTI)

Synonym(s): Nucleoside Analogue Reverse Transcriptase Inhibitor
Antiretroviral (ARV) HIV drug class. Nucleoside reverse transcriptase inhibitors (NRTIs)
block reverse transcriptase (an HIV enzyme). HIV uses reverse transcriptase to convert its
RNA into DNA (reverse transcription). Blocking reverse transcriptase and reverse
transcription prevents HIV from replicating.

Protease Inhibitor (PI)

Antiretroviral (ARV) HIV drug class. Protease inhibitors (PIs) block protease (an HIV
enzyme). By blocking protease, PIs prevent new (immature) HIV from becoming a mature
virus that can infect other CD4 cells.
Fusion Inhibitor

Antiretroviral (ARV) HIV drug class. Fusion inhibitors block the HIV envelope from merging
with the host CD4 cell membrane (fusion). This prevents HIV from entering the CD4 cell.
CCR5 Antagonist
Synonym(s): CCR5 Inhibitor, CCR5 Receptor Blocker
Antiretroviral (ARV) HIV drug class. CCR5 antagonists block the CCR5 coreceptor on the
surface of certain immune cells, such as CD4 T lymphocytes (CD4 cells). This prevents
HIV from entering the cell.
Integrase Strand Transfer Inhibitor (INSTI)
Synonym(s): Integrase Inhibitor
Antiretroviral (ARV) HIV drug class. Integrase strand transfer inhibitors (INSTIs) block

integrase (an HIV enzyme). HIV uses integrase to insert (integrate) its viral DNA into the
DNA of the host CD4 cell. Blocking integrase prevents HIV from replicating.