In every worthwhile relationship, you have to adjust a part of your life to accompany your partner, especially if you live with that person.

Whether it is setting up quality time together amidst your busy schedules or accepting your partner's annoying quirks, a significant part of this relationship is working on the difficult and potentially unpleasant issues.

Being in a serious relationship with a partner is similar to being in a relationship with your medications. You have to work with your pills in order to have them work best for you.

Studies have clearly shown that a decrease in adherence is associated with an increase in treatment failure. A national survey revealed that adherence was associated with how well the regimen fit into an individual's daily lifestyle, and did not correlate with the number of pills taken or the number of medications prescribed. Having the regimen fit into an individual's daily routine is thus a huge focus of adherence.

Talk it over

One important way to address making the regimen fit into an individual's daily routine is to have a discussion with a treatment advocate (TA) or nutrition advocate (NA).

Given the limited time medical providers typically have to spend with patients, many people living with HIV leave their doctor's office confused about their HIV condition and prescribed treatments. In a community setting, TAs and NAs play a vital role in supporting people's medication adherence and in assuring accurate treatment knowledge by reinforcing and verifying understanding.

Here are some reasons why:

• TAs and NAs generally have a lot more time to spend with individuals, which allows for a more accessible environment and enhanced comfort levels.

• TAs and NAs can offer guidance and skills building by providing useful adherence tools such as personal daily medication and meal charts and reminder tools such as pillboxes and timers.

• NAs provide nutrition counseling to help with side effects such as nausea, vomiting, diarrhea, taste changes, dry mouth and difficulty with swallowing. NAs also offer classes. Topics of classes presented by nutrition advocates include:

  • Maintaining Lean Body Mass and BIA Test

  • Managing High Blood Sugar and/or Diabetes

  • Managing High Cholesterol and Triglycerides

  • Coping with Side Effects

  • Analyzing Your Diet

  • Overview of Nutrition and HIV

  • Special Nutrition Needs of Women with HIV

  • Food and Water Safety

TAs and NAs also help individuals communicate more effectively with their doctors to make treatment decisions. Moreover, TAs and NAs offer guidance at a more comprehensive level by linking people to other resources such as housing, mental health and legal services.

What happens in a one-on-one

In one-on-one consultations with an AIDS Project Los Angeles treatment advocate, the following procedures are conducted:

• A personal daily medication and meal schedule is reviewed thoroughly with the support seeker.

• Treatment and adherence concerns are also routinely discussed. An action plan is then created to address any treatment and adherence concerns. The support seekers are given their completed personal daily routine schedule to remind them of their schedule and to write in any comments regarding adherence barriers as they arise.

• For treatment-naïve individuals who are thinking about starting antiretroviral therapy, or who are changing regimens, TAs and NAs can provide information needed to make treatment decisions that will fit their daily lifestyle.

• Treatment advocates provide ongoing support through optional follow-ups. Often, a discussion before or after a medical appointment can be a useful way to consolidate or clarify information.

APLA's Health Education and Advocacy Program is comprised of a team of six treatment advocates and two nutrition experts. This free service is available to all men and women with HIV (client and non-client), in English and Spanish. You do not need to be a registered client of APLA to access these services. For information or to make an appointment, call (323) 993-1529.

Treatment Advocates

Liliana Eagan - (323) 993-1484

Ruben Gamundi - (323) 993-1483

Glenn Gaylord - (323) 993-1509

Nina Marks - (323) 993-1486

John Slovick - (323) 993-1526

William Strain - (323) 993-1459

Health Educator

Nancy Wongvipat, M.P.H. - (323) 993-1511

Nutrition Advocates

Marcy Fenton, m.s., R.D. - (323) 993-1611

Janelle L'heureux, R.D. - (323) 993-1556