Consent for HIV Treatment with Antiretrovirals

Indication for Use

You are requesting treatment with antiretroviral (ARV) medications as part of your treatment plan for the management of Human Immunodeficiency Virus (HIV). Antiretroviral therapy (ART) works by preventing the virus from multiplying in your body. This helps protect your immune system, reduces the risk of illness, and decreases the chance of transmitting HIV to others.

Potential Benefits

• Suppression of HIV viral load (reduction of the virus in your blood to undetectable levels)
• Preservation or improvement of immune system function (CD4 cell counts)
• Reduced risk of developing opportunistic infections and HIV-related complications
• Improved overall health and life expectancy
• Decreased risk of transmitting HIV to sexual partners

Potential Side Effects

While these medications are highly effective, they may also cause side effects. Although not common, some side effects may be serious and could result in hospitalization or rarely life-threatening complications. Side effects can vary depending on the specific medication regimen.

Common Side Effects:

• Nausea or upset stomach
• Diarrhea
• Headache
• Fatigue
• Dizziness
• Sleep disturbances

Serious Side Effects:

• Liver problems (yellowing of skin/eyes, dark urine, abdominal pain)
• Kidney problems
• Severe allergic reactions (rash, swelling, difficulty breathing)
• Changes in heart rhythm (rare, depending on medication)
• Bone thinning (osteopenia/osteoporosis)
• Changes in body fat distribution or cholesterol levels
• Lactic acidosis (rare but potentially serious buildup of lactic acid in the blood)

Risks and Considerations

• Resistance: If not taken as prescribed, HIV may develop resistance to the medications, limiting future treatment options.
• Drug Interactions: Antiretrovirals may interact with other prescription or over-the-counter medications, supplements, or recreational drugs. It is important to tell your provider about all medications you are taking.
• Adherence: Taking your medications exactly as prescribed (daily, on time) is critical to achieving and maintaining viral suppression. Missing doses can increase the risk of treatment failure.
• Monitoring: Regular blood tests are required to monitor your viral load, immune system (CD4 count), liver and kidney function, and cholesterol levels.

Monitoring and Follow-up

You will require regular follow-up visits and blood work to monitor your response to therapy and to assess for side effects. Staying engaged in care and attending appointments are essential parts of successful HIV treatment.

Consent Statement

I acknowledge the potential benefits, risks, and side effects of antiretroviral therapy (ART) for the treatment of HIV. I understand the importance of strict adherence, regular monitoring, and follow-up appointments.