As the saying goes: It takes two to tango.
If you're on HIV treatment, those antiretrovirals you take every day are your lifelong dance partner. With good preparation and coordination, you and your meds will dance together beautifully -- a partnership that will likely keep you healthy for the rest of your (long) life. But if you miss too many steps in the dance, your treatment can stumble -- and so can your long-term health.
"Adherence" is the buzzword that many use to describe whether people take their HIV meds properly -- that is, on time and exactly as prescribed. Today's HIV medication regimens are more powerful than ever; so powerful that if you adhere to them, they can completely stop HIV from replicating in your body. But too many missed doses, or too many doses taken incorrectly, can allow HIV to develop resistance to your meds, reducing your future treatment options and potentially putting you at risk for HIV disease progression.
Drug resistance is the most common reason that HIV treatment regimens stop working. And poor adherence is the most common reason drug resistance happens in the first place. The chemicals contained within your HIV pills need to stay at a certain level within your bloodstream in order to work properly. When you don't adhere -- for instance, by missing too many doses, or by taking your meds with a glass of water when the prescription tells you to take them with a full meal -- it can potentially alter the amount of medication in your bloodstream. That can give HIV the tiny opening it may need to rebound.
There's no perfect answer to the question, "Exactly how many doses of my HIV meds can I afford to miss?" Some medications are more forgiving than others, and a lot depends on the quirks of your own body and immune system. One improperly taken dose is not likely to cause your entire treatment to fail -- but how much wiggle room do you really have? We just don't know.
This is why health care workers are often in a tough position when it's time to talk about adherence: It's hard to know exactly how many antiretroviral doses you need to take properly in a given week (or month, or year) in order to ensure your HIV doesn't have a chance to develop drug resistance. So, many experts will simply urge you to always take your med doses on time and exactly as prescribed: After all, the only way to know for sure how much leeway you have is to miss one dose too many, and by then it might be too late to save your regimen.
Nobody wants his or her HIV treatment to stop working. And it's easy for someone to tell you, "Just take all your meds, and you'll be fine." But the challenge of taking antiretroviral therapy every single day, and the obstacles that life throws in your way, can make adherence a lot tougher in real life than it might seem on paper.
This is why we've created our Resource Center on Keeping Up With Your Meds: to help you get the information and advice you need to ensure that your dance with HIV treatment is as flawless as possible.
Included in this center are:
- A Day in the Life: A series of videos (directed by our lovable, huggable longtime HIV survivor and blogger Mark S. King) that feature HIV-positive people who take us through their typical day, share stories about their obstacles to adherence and talk about how they overcame them.
- Frequently Asked Questions: For many years, top HIV health professionals have staffed our "Ask the Experts" forums and answered questions about every aspect of HIV. Here we share some of the most common and useful answers to adherence-related questions from our readers.
- Six Reasons People Miss Their HIV Medication Doses: Hey, we all would love to be perfect, but sometimes, crap happens. Here are some of the most frequent reasons people end up not adhering to their HIV treatment -- and what you can do about it if these problems happen to you.
- Word on the Street: Advice on Adhering to HIV Treatment: Experts from throughout the HIV/AIDS community offer advice based on their years of experience and knowledge.
- Doctor Discussion Guide: When it comes to good adherence, one of the most important pieces of the puzzle is having a strong relationship with your health care team. We share some important tips on how to make sure you and your doctor, nurse or other health care professional are on the same page.
- Personal Accounts: TheBody.com's bloggers and guest columnists share stories about their own struggles with adherence and how they were able to work through them.
So, whether you're taking a single once-daily pill or a cocktail of several antiretrovirals, keeping up with your HIV meds can sometimes feel overwhelming. Just remember that every dance begins with a single step. We hope this resource center provides a little something for everyone who's seeking to ensure that their own dance with HIV treatment glides beautifully along.
Myles Helfand is the editorial director of TheBody.com and TheBodyPRO.com.