How does your HIV medication make you feel? It’s a question not often asked in discussions of pills. Some people might never think about how meds affect their emotions. But for others, taking pills can be a psychologically fraught experience that stirs up a host of intense feelings. That’s why, when tailoring your treatment to meet your needs, your emotional state and feelings toward your regimen ought to be an important consideraton. 

Taking control of your own treatment plan can also be an empowering act with the potential to change how you feel not only about your medication but also about your life with HIV. 

“If you get treatment out of the way, it opens up the opportunity to work on other life issues,” says Anthony Urbina, MD, the medical director at the Comprehensive Clinic at Mount Sinai’s Institute for Advanced Medicine. “It puts that in a separate bucket, and it’s one less thing to worry about.”

Urbina says he sees people struggle to take their meds for various reasons. These can include work and travel. For some folks, the struggle is social or cultural. Some contend with the persistence and prevalence of HIV stigma. Urbina notes that many of his patients who struggle to take their HIV meds have no problem swallowing daily pills for other health issues, such as diabetes or high cholesterol. 

“I see a lot of Latina women, and for some of them, it is very stigmatizing to be reminded of their HIV by taking their medication daily,” he says. “The stigma associated with HIV has not gone away, and there’s a lot of internal stigma.” 

Urbina says he has conversations with all his patients about adherence and their relationship to their HIV treatment. He wants them to know the facts and make the decisions that are best for them. While the “vast majority” are comfortable staying on their once-daily oral medication, some say they want to switch. 

Often, though, talk of switching can stir up fear. For example, what if after the switch, their numbers change? Urbina says such conversations with your physician can be useful because they get to the heart of what’s most important to you regarding your treatment. Urbina is often able to allay patients’ fears by telling them that he makes it a habit to check viral loads one month after a switch just in case. 

And, he says, long-acting injectables have done a lot to help many people manage their once-negative feelings around treatment. 

“The words I hear most are liberating and freedom,” he says. “It’s very affirming. It’s been very positive.” Urbina says he often sees patients lead an overall healthier life after finally figuring out their treatment. 

“When you’re virologically suppressed, your immune system is stronger, you have less fatigue,” Urbina said. “You have more energy, less depression, your skin is better.”