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What is adherence?
HIV treatment is a partnership. Just as you rely on your antiretrovirals (ARVs) to be proven safe and effective, your ARVs rely on you to take them correctly and on time—every time—so that they can best protect your health. This is called "treatment adherence." And while it may sound easy, sometimes it's not. Though it is very important.
Not taking your ARVs properly can allow HIV to mutate and become resistant to the effect of a drug (or combination of drugs), called "drug resistance." This can cause your meds to stop working properly and limit future treatment options.
What do I need to know to ensure good adherence?
Whether you're selecting a new ARV regimen or currently taking medications, be sure you understand how they're supposed to be taken. You can ask your doctor or pharmacist the following:
- How many pills of each different medicine am I supposed to take at a time?
- How many times a day am I supposed to take each medicine, and when do I take them?
- Should I take my pills on an empty stomach, or should I take them with food?
- Can I take my ARVs with other meds I'm taking? And what about supplements, herbs and over-the-counter medications?
- What should I do if I forget a dose?
How can I improve my adherence?
There are a number of issues that can impair someone's ability to adhere to a strict medication schedule. By communicating with your health care provider, you can figure out if there are any obstacles in your way—and figure out strategies to overcome them:
- Complicated regimens. ARV combinations are more powerful and effective than ever before in helping HIV-positive people live longer and healthier lives. Drug regimens are also much easier to take—fewer daily doses and fewer pills that must be swallowed every day—than when combination therapy first became standard treatment approximately 10 years ago. If simplified treatment, including regimens that only need to be taken once a day, might be helpful to you, talk with your health care provider.
- Depression and stress. Studies show that people who are depressed or who live chaotic lives can have a harder time with adherence. Fortunately, depression is treatable and case managers at a local AIDS service organization (ASO) may be able to help you reduce the stress and chaos in your life.
- Empty pill bottles. We've all been there: taken our last pill out of the bottle on a day that the pharmacy is closed or find out that it might take a few days for the prescription to be refilled. Once you're down to five days' worth of medication, make the call to refill. And don't panic if you're out of refills or find yourself away from home without meds—pharmacies will sometimes give you a couple of days' worth of meds in case of an emergency.
Quick Tips
Here are tried and true methods to keep you on top of your meds.
- Manage: Lay out your meds in advance with a weekly or monthly pillbox, or have your meds "prepackaged" for you by your pharmacy.
- Accessorize: Portable pillboxes and timers help keep you adherent when you're on the go.
- Practice: Some folks prepare for a new HIV regimen by practicing for a week with jellybeans to identify in advance where they might have problems.
- Put you first: We often lose ourselves in our responsibilities to others, like family or work. Ask for help if they're causing you to forget doses.
- Keep 'em handy: Keep your meds close to something you use consistently, like a toothbrush, coffeemaker or your alarm clock.
- Plan ahead: Ask your doc in advance what you should do if you realize you've forgotten to take a dose.
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