What Is Adherence?

Adherence refers to how closely you follow a prescribed treatment regimen. It includes your willingness to start treatment and your ability to take medications exactly as directed.

Is Adherence Important for HIV Treatment?

Yes! Adherence is a major issue in HIV treatment for two reasons:

• Adherence affects how well anti-HIV medications decrease your viral load. When you skip a medication dose, even just once, the virus has the opportunity to reproduce more rapidly. Keeping HIV replication at a minimum is essential for preventing AIDS-related conditions and death.
• Adherence to HIV treatment helps prevent drug resistance. When you skip doses, you may develop strains of HIV that are resistant to the medications you are taking and even to medications you have not yet taken. This may leave you with fewer treatment options should you need to change treatment regimens in the future. Because drug-resistant strains can be transmitted to others, engaging in risky behavior can have especially serious consequences.

Although there are many different anti-HIV medications and treatment regimens, studies show that your first regimen has the best chance for long-term success. Taking your anti-HIV medications correctly (adherence) increases your odds of success.

Why Is Adherence Difficult for Many People With HIV?

HIV treatment regimens can be complicated; most regimens involve taking multiple pills each day. Some anti-HIV medications must be taken on an empty stomach, while others must be taken with meals or before or after doses of other medications. This can be difficult for many people, especially for those who are sick or are experiencing HIV symptoms or negative side effects caused by their medications.

Other factors that can make it difficult to adhere to an HIV treatment regimen include:

• Experiencing unpleasant side effects to your medications (such as nausea)
• Sleeping through doses
• Traveling away from home
• Being too busy
• Feeling sick or depressed
• Forgetting to take medications

What Can I Do to Adhere to My Treatment Regimen?

There are many things you can do to better adhere to your treatment regimen. Adhering to My HIV Treatment Regimen Fact Sheet discusses what you can do to improve your adherence both before and after you start taking anti-HIV medications.

One of the most important things you can do when starting a treatment regimen is to talk with your doctor about your lifestyle. He or she will then be able to prescribe a regimen that works best for you. Topics you should address with your doctor include:

• Your work, sleep, eating, and travel schedules
• Possible side effects of medications
• Other medications you are taking and their possible interaction with anti-HIV medications
• Your level of commitment to following an HIV treatment regimen

Many people adhere well to their treatment early on but find adherence becomes more difficult over time. Talk with your doctor about adherence during every visit. Your commitment to a treatment plan is critical; studies show that patients who take their medications correctly achieve the best results.

For More Information

Contact your doctor or an AIDSinfo Health Information Specialist at 1–800–448–0440 or http://aidsinfo.nih.gov.

Terms Used in This Fact Sheet Drug resistance: HIV can mutate (change form), resulting in HIV that cannot be controlled with certain medications. Viral load: the amount of HIV in a sample of blood.

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