The Evolution of HIV Medication

Jun 15, 2022


Alto Pharmacy

HIV treatment has transformed drastically since the virus was first discovered in the U.S. more than four decades ago. While there is no cure, HIV — short for human immunodeficiency virus — has become a manageable chronic health condition like many others.

Today, the majority of HIV cases in the U.S. do not progress into AIDS, the most advanced stage of HIV. Not only that, but also 57% of individuals living with HIV are not at risk of transmitting the virus to others.

That’s a testament to the effectiveness of antiretroviral therapy (ART), the frontline treatment for HIV. ART is a combination of medications that keep HIV from replicating, stopping the progression of the virus and preventing transmission.

Take a look at the evolution of treatment for HIV and learn how ART works.

Early HIV medication and the introduction of ART

HIV is a virus that attacks your immune system, making you more vulnerable to other illnesses. It is transmitted through contact with the blood, semen, or vaginal fluids of someone who has HIV. As the virus replicates and spreads, it destroys your CD4 cells, a type of white blood cell that plays a role in your immune system.

The first antiretroviral HIV/AIDS medication, azidothymidine (AZT), was approved to treat HIV in 1987. AZT blocked proteins that allowed the virus to replicate and spread. A so-called “monotherapy” consisting of a single medication, it had promising results in early clinical trials but ultimately proved ineffective in slowing the progression of HIV. This was due in large part to the fact that HIV can quickly change into new forms that are resistant to an individual medication.

The introduction of ART in 1995 was a significant breakthrough. By combining multiple HIV medications, it helped prevent the virus’ resistance to a single medication.

Understanding ART

ART is a combination of medications that lower your viral load, which is the amount of HIV in your bloodstream. When taken every day as prescribed, these medications can help individuals with HIV maintain an undetectable viral load, virtually eliminating their risk of transmitting the virus to others. This both preserves the strength of your immune system and protects the health of your sexual partners. Many people living with HIV are able to achieve an undetectable viral load within six months of starting ART.

There are several FDA-approved ART therapies available by prescription. Each medication included in the therapy plays a critical role. Collectively, these medications prevent the virus from replicating, reduce your viral load, increase your CD4 count, and restore your immune system.

Currently, there are five types of medications included in ART therapies.

  • Nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcription inhibitors (NNRTIs), and protease inhibitors (PIs) prevent HIV from replicating.

  • Entry or fusion inhibitors prevent HIV from penetrating CD4 cells.

  • Integrase inhibitors (INSTIs) target a critical step in the replication of the virus, preventing replication after HIV has entered a CD4 cell.

Most of today’s HIV treatment protocols combine three medications from two or more of the five classes above. Medical advancements continue to simplify ART, with medication protocols that consist of a single daily pill or a monthly injection.

Your provider will closely monitor your body’s response to your protocol. Thanks to the variety of options, it is easy to make adjustments as needed if you experience side effects or don’t achieve the desired results.

Getting started with HIV medications

HIV treatment is critical for anyone living with the virus, regardless of how long they have had it. If you have been diagnosed with HIV, starting ART as quickly as possible is the most important thing you can do to protect your health and others.

There are several ways to find a healthcare provider for HIV treatment.

  • If you have a primary care provider, ask if they offer HIV treatment or can give you a referral.

  • If you tested for HIV at a clinic, ask if they offer HIV treatment or can give you a referral.

  • Use’s search tool to find HIV treatment services near you.

Some HIV medications can prevent transmission of the virus to a developing baby. If you or your partner is pregnant, or if you are considering starting a family, let your healthcare provider know so they can recommend the best treatment option.

Taking ART as prescribed in the long term is critical to its effectiveness. That includes not only taking the medication itself, but also attending follow-up appointments and completing lab tests.

If you are having trouble staying on track with treatment, ask your provider or pharmacist for suggestions. Many individuals find it helpful to combine their HIV medication with another daily habit such as brushing their teeth, or to set a reminder on their phone. The Alto app has medication management reminders to help you continue with your treatment.

HIV prevention medication

If you have tested negative for HIV, there are important HIV prevention medications that can help you continue to protect your health.

PrEP, or pre-exposure prophylaxis, can lower risk of sexual transmission of HIV by 99% when taken as prescribed. It also reduces the risk of getting HIV from intravenous drug use by about 74%. PrEP may be right for you if you have a partner who is HIV-positive or unsure of their HIV status, or if you have multiple partners.

Read Debunking Common Myths about PrEP for more on getting started with PrEP.


PEP, or post-exposure prophylaxis, is a medication taken within 72 hours of potential exposure to HIV to lower your chances of contracting the virus. It is only for emergencies and accidental exposures. If you anticipate ongoing risk of exposure to HIV, speak with your doctor about potentially taking PrEP for long-term protection.

Financial resources for HIV treatment and prevention

For many individuals, cost is a barrier to both starting and continuing to take ART and PrEP as prescribed. Fortunately, HIV prevention medication and treatment continue to become more accessible, with generic PrEP options and expanded health insurance coverage of PrEP and ART.

The following resources can also help reduce the cost of HIV treatment and prevention medication:

Get support navigating HIV treatment and prevention medication

Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started and stay on track with ART, PrEP, or PEP. We will coordinate with your healthcare and insurance providers to ensure that you’re receiving the best option for your needs at the best price.

Reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

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