Treatment Adherence

What is treatment adherence?

Treatment adherence means adhering to (following) your treatment regimen -- taking the correct dose of each anti-HIV medication at the correct time and exactly as prescribed. Adherence is very important for successful HIV treatment.

Why is adherence important?

Adherence affects the success of HIV treatment in two ways:

• Good adherence to an HIV treatment regimen helps anti-HIV medications work effectively to reduce the amount of HIV in the body (viral load). Skipping medications, even occasionally, gives HIV the chance to multiply rapidly. Preventing the virus from multiplying is the best way to stay healthy.
• Good adherence to an HIV treatment regimen also helps prevent drug resistance. Drug resistance develops when the virus mutates (changes form), becoming "resistant" to certain anti-HIV medications. One or more anti-HIV medications in a treatment regimen can become ineffective as a result of drug resistance.

  Skipping medications makes it easier for drug resistance to develop. HIV can develop resistance to the anti-HIV medications in a person's current regimen or to other, similar anti-HIV medications not yet taken, limiting options for successful HIV treatment. And drug-resistant strains of HIV can be transmitted to others, too.

Although there are many different anti-HIV medications and treatment regimens, studies show that a person's first regimen offers the best chance for long-term treatment success. Adhering to your regimen from the start will help ensure your HIV treatment is successful.

Why is treatment adherence sometimes difficult?

There are several reasons why adhering to an HIV treatment regimen can be difficult. Most treatment regimens involve taking several pills every day -- with or without food, or before or after other medications. Other factors that can make treatment adherence difficult include:

• Difficulty taking medications (such as trouble swallowing pills)
• Side effects from medications (for example, fatigue or diarrhea)
• Daily schedule issues (including a busy schedule, shift work, or travel away from home)
• Being sick or depressed
• Alcohol or drug abuse

What can I do to adhere to my HIV treatment regimen?

Before you start treatment, be certain you're committed to taking anti-HIV medications every day as directed. Talk to your health care provider about any issues that may make adherence difficult:

• Possible side effects from the anti-HIV medications in your regimen
• How other medications you take may interact with your anti-HIV medications
• Your schedule at home and at work
• Any personal issues such as depression or alcohol or drug abuse
• Lack of health insurance to pay for anti-HIV medications

Understanding issues that can make adherence difficult will help you and your health care provider select the best regimen for you. Some people may find that adhering to an HIV treatment regimen becomes more difficult over time. So, talk to your health care provider about adherence at every visit. (See the Following an HIV Treatment Regimen fact sheet for tips on adherence.)

For More Information

Contact an AIDSinfo health information specialist at 1–800–448–0440 or visit http://aidsinfo.nih.gov. See your health care provider for medical advice.

This information is based on the U.S. Department of Health and Human Services' Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents (available at http://aidsinfo.nih.gov/Guidelines/).