00:01
So what is this
miracle treatment?
Well antiretroviral treatment.
00:05
We also call it ART, right?
Antiretroviral therapy, ART.
00:09
There the drugs that are
used to treat HIV that virus.
00:13
Okay so that's easy to remember
antiretroviral HIV is a virus
and we call it ART for short.
00:21
So many people living with HIV.
00:23
I promise this is
such an amazing time
compared to when the disease
was first discovered.
00:29
People were terrified,
they were afraid,
we didn't understand how it worked.
00:32
We didn't think we had
any options for treatment.
00:35
Now, we really do have some
pretty exciting options.
00:38
So it's not a cure.
00:40
I understand that
but it can keep HIV
effectively under control
so we can't cure it yet,
but we can control it
with adequate treatment.
00:51
So let's talk about how this
amazing therapy or treatment works.
00:55
ART works by keeping
the level of HIV
in your body very low.
00:59
So the Lower the number
of viruses in your blood
that's a positive thing
the number of viruses in your
blood is called viral load.
01:09
So those are key terms
you want to make sure
that you recognize those.
01:12
So viral load is the
number of HIV viruses
in your blood the goal to
have as few as possible
because the lower
the viral loads
allow my own immune
system to recover
and stay strong.
01:26
Well that makes sense
because the less virus I have is
hijacking my own immune system
my own immune syste is going
to be able to stay strong
and fight off infections.
01:36
So also keeping it low.
01:38
Remember we want
to remind you that
it stops HIV from
being passed on
which is clearly and obviously
critically important,
but the challenge is
consistency in ART.
01:50
The patient has to
take the drug every day
relatively the same time
if they can do that
it will significantly
extend the life expectancy
of someone with HIV.
02:01
But there's the
biggest challenge
is consistently taking the
medication on a daily basis
at the same time.
02:09
See that's the part where we
can help support the patient
educate the patient
and help them problem solve
with the challenges
each individual faces
with doing something every day.
02:21
So here's the goal,
undetectable viral load.
02:26
This is a huge win for
somebody who's hiv-positive.
02:30
So if we can keep that
treatment consistently going
they follow it as it was
prescribed, people living with HIV
are really achieving that
undetectable viral load.
02:39
That means that virus is
in such a small quantity
in their bloodstream
that it doesn't
affect their health
and it limits the risk of them
transmitting the virus to others.
02:49
Now the patient still
has HIV technically
but we're keeping
it under control.
02:55
So undetectable viral
load doesn't mean
whoo! I've been cured.
02:59
It just means I still have this.
03:01
I'm still living with this.
03:03
However,
it's under tight control.
03:06
There should be low risk for
passing that on to anyone else
and this individuals life
and immune system are
both going to be stronger.
03:14
Now if the patient stops
taking the medication regimen
for any reason,
they're not consistent
with it again,
the viral load will go back up.
03:24
I know we've said that
multiple different ways.
03:25
That's always one
of our strategies
with you is to use repetition
to make sure that
things are making sense.
03:31
But this is the
most important point
that you can help your
patient understand.
03:37
Here's our goal
undetectable viral load.
03:40
You'll be less impacted
your family and people that you
care about will be less impacted
by the risk of transmission.
03:46
However, if for some reason
you're finding barriers
to taking the medication,
please contact us quickly
because you have to take it
consistently to get to this goal
of an undetectable viral load.
04:00
Now, what are the ways
we use these medications,
Now there are several different
types of antiretroviral or ARV drugs
and they work in different ways.
04:09
Just like if someone
had an infection,
we can give a couple of
different antibiotics
that have different
mechanisms of action.
04:15
If someone has hypertension,
we give sometimes more than one
two, three, four, five medications
for really severe hypertension
because they work in different
mechanisms of action.
04:27
Same thing with treating HIV.
04:29
In fact,
the World Health Organization
recommends a combination
of antiretroviral drugs for
people starting HIV treatment.
04:36
So the often recommend you be
on more than one drug
for treating HIV.
04:42
So usually it's about three
or more of the drugs
are taken together.
04:46
Sometimes some of these drugs
are even combined into one pill,
which is really
helpful for patients,
because you know, it's hard to
remember to do
something every day.
04:55
It just is bright, sharp,
intelligent people.
04:59
We sometimes forget.
05:00
I know I plotted my driveway
and as I'm driving up
and thinking like did
that garage door closed
did I turn the iron off
all those kinds of things
that go through your mind?
So you have to help your patients
develop a system of reminders,
so they'll know
yes they did or no,
they didn't and remind them to do it
because they're going
to have to have some
type of system in order
to take this medication
as it's prescribed.
05:25
So every day roughly
the same time.
05:29
So usually you're going to need
to help work with the patient
actually have the
discussion for them
what works best for you.
05:36
Are you a paper calendar person?
Are you a digital person,
do use your phone.
05:41
Do you not use your phone?
So work with them
within the systems
that they're already using
to help them be successful
in taking these medications
as it's prescribed everyday.
05:52
It's going to take nurse-patient
collaboration to
work for a plan.
05:57
Just don't throw this
out there for patient
and expect them to
pull it all together.
06:01
This is a lot to deal with
this is a lot of
overwhelming information
for someone who's
not used to this.
06:08
Wait a minute,
even if it was a
healthcare professional
this would be a lot of
information for someone to take.
06:14
So be patient, collaborate,
work with them.
06:17
Listen to their life.
06:19
Listen to what they think
might be challenges,
help them problem solve.
06:23
They need to plan ahead.
06:24
What if they're
going on vacation?
That's awesome.
06:27
But that means
they could be away
for extended period of time.
06:31
How are they going
to stay on schedule?
Are they going to be in
a different time zone?
Do they have enough medication
through their insurance plan or not?
However,
they get their medications
that they'll have enough
in case they covers over
different prescription times.
06:45
So these are all things that
sometimes people don't think about
if you've been a health care
provider you these are concerns.
06:52
That's why it's our
role to bring them up
and have the discussion
with the patient.
06:57
Now sometimes people experience
side effects with this treatment
all medications usually have
some type of side effect,
but like other medications the
side effects usually go away
if they can hang in there.
07:10
So if they stick around
we can maybe look at
switching the ARV treatment
with the health care provider
to a different
combination of drugs.
07:18
So that would involve you having
open therapeutic communication
with your patient
and being a liaison
for your patient
and advocating with the
healthcare provider.
07:27
Who will be very open to
coming up with a new plan.
07:31
Physicians and
Healthcare professionals
that are used to prescribing
these medications
understand that this
is a common thing
since we all want
compliance for the patient
everyone works together to help them
find a combination treatment plan
that's effective and with
tolerable side effects.
07:50
Now, let's talk about some
of those side effects.
07:52
Now EFV, you can see
why we shorten that one
it often causes us some weird,
I mean really weird dreams
in the first few
weeks of taking it.
08:03
So that's going to
be kind of unsettling
for the patient who's taking it
make them aware of it
before they start taking
the medication know that
some people have reported
when they first start
taking this medication.
08:15
They have some strange dreams.
08:17
It usually should go away
after the first few weeks,
but we wanted you
to be aware of it.
08:22
That way when they do
start having the dreams
they know that this
It'd be an example
of side effect of
the medication.
08:29
They know they're
not going crazy
or anything like that.
08:33
Now there's some other
side effects TDF.
08:35
This can cause
problems with kidneys.
08:37
So if this is one of the medications
the patient is prescribed,
then the healthcare team
will need to monitor
their renal function.