My partner was diagnosed with HIV in 2005. When he first started medication he adhered well for a few years. Then, he decided that he wasn't going to take it anymore. He was a poster boy for Atripla and all of his counts normalized and his side effects were minimal. He made this decision on his own. He refuses to take blood tests anymore, instead opting for exercise and a new diet. He is reluctant to go to the doctor for anything at all, and gets very defensive when I ask if he is taking his meds or not. He tells me it's his business and not mine. We have been together for 20 years and I have nobody to talk to about it. He refuses to see a psychiatrist and doesn't appear to have any kind of death wish. Is there anything to do about this? I've spoken to his doctor and she is as frustrated as I am, but is bound to follow his instructions and his refusal to take tests.

Thanks for writing. I wish I had a simple answer for this difficult situation. Adherence issues are complicated because they can result from so many factors. While exercise and diets are excellent factors for living well with HIV, a refusal to take medications is of great concern. It is significant that he adhered so well but then suddenly changed. It would be helpful to know what changes, events, or information resulted in this decision. Understanding his motivation might eventually led to a reversal.

Even though he is refusing to seek help at this time, I would encourage you to get some counseling to help you deal with your own feelings about this situation. A counselor could also help you clarify your role (which may be letting go of his decision) and assist you with devising strategies.

Take care.