In the early days, South Africa started the free rollout of ARV treatment in April 2004. In my case, diagnosed in 2004, ARV’s were only administered to me in 2008 and not provided ARV treatment until our CD4 was below 200. Years later, ARV’s were recommended at 350 and, still later, at 500 CD4 counts. Normal levels of a CD4 cell count indicate the health of your immune system. The levels of a person who does not have HIV can be anything between 500 and 1500.


Currently, South Africa has implemented guidelines that provide insight into how and when treatment gets supplied, declaring: Who is eligible? ‘All people, regardless of age, CD4 cell count and clinical stage. ART should be initiated within seven days unless there is a reason to defer. Same-day initiation is encouraged if the client is clinically well and motivated.’


  • ARV – Antiretroviral – usually refers to the medication
  • ART – Antiretroviral Therapy/Treatment


According to the Western Cape Department of Health (DoH), you should start taking HIV treatment immediately on diagnosis, and at the very least, within seven days, circumstances permitting. Advantages of HIV treatment: Once your viral load is undetectable, you cannot pass on HIV to partners. (It might take up to six months on treatment to become undetectable.) U=U means Undetectable = Untransmittable. hiv_guidelines_16012020.pdf ( 


Antiretroviral therapy keeps HIV from making copies of itself. On first starting ARVs for your antiretroviral treatment, your HIV levels should drop significantly. Here is when viral load testing comes in. During the first two months of therapy, an HIV-positive person’s viral load should drop to a minimum of 90 per cent.


Benefits of starting immediately:

  • An extended life.
  • Reaching a higher CD4 count and keeping it high.
  • Blocking additional damage to the immune system.
  • Lessening the risk for HIV-related and non-HIV-related health complications.
  • Reducing your risk of transmitting HIV to others.


Risks of delayed treatment:

  • A shorter life
  • An extremely weakened immune system. This can lead to it taking longer to repair your immune system later, and your condition can potentially develop into AIDS and other serious illnesses.
  • An accelerated chance of your failing health advancing some infections when you begin taking HIV drugs later, and have limited CD4 cells.
  • Transmitting HIV to others, inclusive of sexual partners and babies, if you become pregnant.


Blood Tests:

You will have baseline blood tests done prior to starting HIV treatment. Your healthcare worker will take blood for various tests. These are your original, or baseline, tests and subsequent test results will be compared to these original test results to check how your treatment is working.

  1. CD4 cell (T-cell) count: The CD4 count checks the strength of your immune system. After you start HIV treatment, if your CD4 count is low, you should see it go up. Initially, your CD4 count should be checked every three to four months. When this count becomes stable, it should be checked every six months to one year.
  2. Viral load test: The viral load (VL) test measures the amount of HIV in your blood. After you start HIV treatment, you should see your viral load go down. Your viral load should be checked around a month after starting or changing HIV medication. Your VL should be tested every three to four months until it becomes undetectable in your bloodstream. Your VL should be checked every six months once stable.
  3. Resistance test: The resistance test helps regulate which drugs are likely to work against the strain of HIV that you have. Experts recommend that everyone get a resistance test before starting or changing HIV treatment. (HIV-1 has nine named strains: A, B, C, D, F, G, H, J, and K. Some of these have sub-strains).
  4. Other tests to check your overall health: These include complete blood count (CBC), chemistry screen, lipid profile (cholesterol and fat), liver tests, and glucose(blood sugar). Your healthcare provider should inform you how often you will require these tests.


A chronic condition can affect anyone. How you manage it is what makes the difference.

You can get coverage of up to 1 million rands for your chronic health condition and up to 10 million if you are living with HIV.

SMS CHRONIC to 33857 to find out more.

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