I take Truvada, Reyataz, Norvir with dinner each night. I am concerned about whether I am running the risk of developing resistance if I take my meds at 6pm one night but do not take them until 8pm the following night because I have dinner later.
Do I have to take my meds at the exact same time? How concerned should I be if I am eating 2 hours earlier or later from one night to the next?
You should only take a final answer to this question from your doctor. It is important that you talk about these kinds of irregularities in your adherence schedule and that together you agree on a plan that meets your needs while respecting his or her plan for your health.
My opinion is that two hours on either side of a standard time for dosing with boosted atazanavir (i.e. Reyataz plus Norvir) is acceptable. My priority in this instance would be to ensure that you were able to take the medication with a meal, as GI side effects such as nausea and diarrhea are less frequent when you take this regimen with a meal. The pharmacology of the drugs you are taking will safely allow for intervals of 22 - 26 hours. However, I would urge you not to delay any longer than that (i.e. over 26 hours between doses), and, if possible, I would encourage you to find a working compromise that allows you to take the dose every 24 hours, as recommended.
And, as above, please discuss this question and the above response with your doctor.