HIV Treatment Adherence: Recently Asked Questions

Executive Editor
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At's "Ask the Experts" forums, our team of experienced, knowledgeable HIV physicians regularly tackles a wide range of questions from people living with HIV. Those questions often include concerns from people who are on HIV treatment but run into problems taking their meds exactly as prescribed and are worried about the consequences of missed, late, early or incorrect doses.

Here are some of the important questions about HIV treatment adherence our experts answered from January through November 2016.

Questions have been condensed and edited for clarity.

Life On/Off HIV Medications

Coping With a Life on Treatment
I have been positive since birth -- that would be 21 years to be precise -- and I have only taken antiretrovirals for two years on and off. Now, I have completely stopped taking them because of the side effects, which were interfering with my routine and have me scared about permanent damage. Do I really even need to be on these drugs? Read the answer >>

Explaining to My New Doc Why I'm off HIV Meds
After being diagnosed in 1999 and taking HIV treatment for a while, I decided to stop going to my doctor and go off meds. It's been well over a decade since, and I've felt healthy this whole time. I recently moved and don't know how to explain this to my next doctor without him judging me. Do you have advice? Read the answer >>

My Meds Are About to Expire
On my box of HIV medications, it says the expiry date is end of the month. But when the month ends, I'll still have 15 pills left in the box. Is it safe to take them? Read the answer >>

It's Hard to Swallow My HIV Meds
I'm a long-term HIV-positive survivor who recently began taking a regimen that includes football-size pills. I've tried everything to get these things down but nothing works, and I feel frantic every time I attempt to consume one. What can I do? Read the answer >>

Tip for Those With Trouble Swallowing Pills
I read your recent answer regarding difficulty in taking/swallowing HIV medications. I have a solution: Dissolve the tablet in a small glass of water, then drink it. Read the answer >>

Another Pill-Swallowing Tip
Here's a method I have used: A little olive oil or vegetable oil will help a large pill go down. Read the answer >>

Tweaking Your Antiretroviral Regimen

Do Drug Doses Have to Be So Large?
I got fed up with taking HIV meds every day, so for the past few years I've taken them only twice a week at best. My CD4 is still pretty good and my viral load is undetectable. Do we really need to take all these drugs as prescribed? Could doses be smaller? Read the answer >>

Can I Just Dump One Drug in My Regimen?
My doctor thinks that it might be OK to change my regimen from Atripla (which contains Emtriva (emtricitabine), Sustiva (efavirenz) and Viread (tenofovir, TDF) to only Emtriva plus Sustiva. I've been undetectable for seven years and have a very high CD4 count, but he's concerned about the long-term side effects of Viread. What do you think? Read the answer >>

Can I Make a Twice-Daily Drug Into a Once-Daily Drug?
I know that Isentress (raltegravir) is supposed to be taken twice a day, but I prefer to take both doses once a day (at the same time as the other pills in my regimen). Is this OK? Read the answer >>

Dosing Schedules (Missed Doses, Late Doses, Dose Timing, Etc.)

Do a Few Late Doses Spell Resistance?
Is it OK if I sometimes take my HIV medications a little bit later than I'm technically supposed to, or will I increase my risk of developing drug resistance? Read the answer >>

How Often Can I Change My Dose Time?
I've heard that HIV meds don't need to be taken at precisely the same time every day. But just how late can I permit myself to be with a dose? One hour? Two? Five? Read the answer >>

The Holiday Weekend Messed Up My Regimen
My HIV treatment regimen consists of two pills, but I was unable to fill the prescription for one of them over the holiday weekend. I'll have missed four doses by the time I pick it up. However, I have continued taking my other set of pills without interruption. Is this OK? Read the answer >>

Double the Dose, Double the Trouble?
I've been taking Triumeq (abacavir/dolutegravir/lamivudine) since May 2015. Today, my schedule made me a bit confused, so I might have taken two pills instead of one. Was this dangerous? Read the answer >>

The Best Way to Ration HIV Meds
I am normally 100% adherent, but through circumstances beyond my control, I am on a six-day trip and only have three pills. What's the best way to handle this? Read the answer >>

Treatment Holidays (Taking a Break From Meds)

Can My HIV Become Resistant While I'm off Meds?
I stopped using my HIV drugs for over 10 years. I'm finally ready to start fresh, but I'm worried: Is it possible HIV has formed resistance to medications during my long time off meds? Read the answer >>

Should I Stop HIV Meds During Pregnancy?
My doctor suggested I stop taking antiretrovirals for three months while I'm pregnant, warning that the meds can cause miscarriage. Is that true? Is it safe for me to pause my HIV treatment? Read the answer >>

Can I Stop Meds to Troubleshoot Side Effects?
My son has been on HIV treatment for six months. He switched off his first regimen after three months because of severe diarrhea, but it has continued since he switched. He wants to take a five-day break from meds to see whether they're truly the cause. Does this sound OK to you? Read the answer >>

Pause HIV Treatment for My Liver's Sake?
I have been on HIV meds for four months now. My viral load has gone down to 20, but my liver tests are abnormally high. My doctor advises that I stop the Atripla for one month to see if that's the cause, but I'm afraid I'll develop resistance. What should I do? Read the answer >>

Should I Hold Off on HIV Meds Before Surgery?
Unfortunately, I have to have major surgery (not related to HIV) in a few weeks. I take my meds in the morning with breakfast. However, I can't eat before the surgery. What should I do with regards to med doses? Read the answer >>

International Travel

Can I Safely Pause My Meds While Traveling?
I am going out of the country for nine weeks, but due to a delivery problem I only have three weeks of HIV meds left. Will going off treatment for six weeks lead to drug resistance and reduce my CD4 count? Read the answer >>

What if I Run Out of Pills?
I have rarely missed a dose of my HIV meds in the past seven years, but now that's about to change: I live overseas; my new shipment of meds hasn't arrived; and I'm down to my last dose. Depending upon how long the lapse is, how concerned should I be? Will I need to get a resistance test? Read the answer >>

If I'm Out of One Med, Do I Stop Them All?
We are a 48-year-old couple who recently moved to Peru. We had our medications shipped from Barcelona, Spain, but they have not arrived yet. We are now out of most of our meds. We are taking one pill of Truvada ((tenofovir/FTC) per day, which we hope we can do until our meds arrive. Is this OK? Read the answer >>

Expiring Meds While Traveling Abroad
I am a student traveling in another country, and I just discovered my HIV meds are expiring this month. I can't get back to my home country in time to get a new prescription. Do I need to find a way to get more medications in the country where I'm staying? Read the answer >>

What If I Can't Access My Regimen?
I've been on successful HIV treatment for 10 years. I'm moving to a country where the regimen I take is not available yet. I'm considering switching back to my previous regimen. What do you think I should do? Read the answer >>

HIV Care in Mexico
I am on HIV treatment and will be traveling from the U.S. to Mexico soon for work. Will I be provided medicines by the Mexican government for free or will I have to bear the cost? Can I bring HIV medications with me? Read the answer >>

Myles Helfand is the editorial director of and

Follow Myles on Twitter: @MylesatTheBody.