Patrick Ingram remembers the very first thing his doctor warned him about when deciding to go on HIV medication for the first time. “Don’t start until you’re ready,” she said. “You’re going to have to take these every day for the rest of your life.” 

She added, “I don’t want to prescribe these to you and have you start taking medications if you’re not ready to make that lifelong commitment.” 

Ingram, who is 36, didn’t start taking medications directly at the time of his diagnosis, as is usually the protocol now, but instead had a talk with his doctor about when would be the best time to begin. She warned him that once he began taking medication, if he forgot too often, he risked developing a resistance, as well as other potential health issues. 

Eleven years later, Ingram stopped taking daily medication, but that doesn’t mean he wasn’t following doctor’s orders. In April 2022, he switched to a long-acting injectable HIV medication. He even shared his journey getting the shots taken on his video blog, The Poz+ Life of Patrick, which has over 8,000 subscribers. Since first uploading the video to YouTube, viewers have watched him take his first dose over 10,000 times. 

Ingram was diagnosed on December 1, 2011, on World AIDS Day, but sought care shortly after at a popular clinic in Washington, DC. He was living nearby in Virginia and training to be a part of the U.S. Coast Guard in Virginia when he started to experience a spate of symptoms, including oral thrush, persistent diarrhea and weight loss. After a lot of online searching, Ingram decided to take an HIV test and after his diagnosis and decision to start treatment, he was put on a regimen that included multiple pills a day. 

Though he eventually switched to a once daily pill, over time his relationship to medication changed as his life did. While working as a flight attendant with an erratic schedule and changing time zones, taking his daily pill would sometimes slip his mind. “I’d be flying across the Atlantic, leaving New York to go to Greece and forget to take my meds,” he said.

And, as he grew older, responsibilities began to mount: he is pursuing his doctorate degree and he and his husband are trying to adopt a child, they already have four dogs and a cat. Together, they weather the stresses of owning a home. And, getting older, he has added several medications — including statins and medication for mental health and prediabetes — to his regimen, making his pill burden feel even heavier.  

For him, the conversation about long-acting HIV treatment became the answer to a simple question: “How can I take at least one thing off the table?” 

Long-acting injectables have given him a mental and physical gift. “It provides a level of freedom,” he said. “I’m not so fixated every day on ‘Did I take my medication?’” He added, “My focus has now shifted to making my appointments.” 

Making appointments with his physician isn’t a problem for him, though. He loves his care team and getting face time with them. Ingram says that having a good care team behind him was essential to his success on his new regimen. “I’d rather come in and see a nurse and also have my STI [sexually transmitted infection] testing paired with that,” he said. “So I don’t mind, it worked for me.” 

Even though he first heard about long-acting injectables through his work in public health, he spoke with his primary care doctor about updates in the field of HIV medicine, including asking them if they’re attending conferences or reading new medical literature. 

“I’ve always had my ear to the ground of what’s happening in the treatment world because, as somebody living with HIV, I think it’s important to know what’s in the market and what’s available,” Ingram said. “That’s important, especially if it has the ability to make my quality of life much better.” 

Switching to a long-acting injectable HIV treatment has been much better for him in terms of side effects. He had only slight discomfort from his first injection and that soreness lessened with each trip to the doctor’s office. He’s found these side effects more manageable than the ones he dealt with on his prior one-pill regimen. In fact, during his first video on his new treatment, he showed himself doing post-injection stretches in order to keep the site moving and relieve discomfort. He also mentioned that he took over-the-counter pain relievers after the first dose. 

Because life for Ingram since his diagnosis has been a world full of pills, this new regimen has also forced him to rethink his relationship with HIV. For a long time, he said, his daily pill has been a reminder of one of the worst periods of his life. 

“My brain, over these years, has been programmed to think that an oral medication is what keeps me alive,” Ingram said. He no longer feels the rush of forgetting medication and realizing that, if he doesn’t take his pill right now, there could be dire consequences. 

That doesn’t mean that he doesn’t think about HIV. As a public health worker, he is always thinking about the ongoing epidemic, but his personal relationship with his own diagnosis has changed significantly. 

“I’ll never go through a day not thinking about HIV,” he said. “But what I can say is that I am less stressed about my own HIV.”