Adherence and why it is so important
What is adherence?
Adherence is a word to describe taking your drugs exactly as prescribed. This includes taking them at the right time. It also includes following any special diet restrictions.
- Adherence is the most important thing you have to think about when you start taking a new combination.
- This makes sure that all the drugs in your combination are at high enough levels to keep HIV under control 24 hours a day.
- Developing a routine or daily schedule can really help. You may need some support to get used to the changes treatment makes in your life. Adherence can be very difficult.
- Start treatment when you can give yourself the extra time and space you may need to adjust.
- During the first few weeks nothing else should take priority over getting your treatment right.
- Some treatment centres have a health advisor who can help you.
How much is enough?
Unfortunately, the answer is ‘almost 100%’… Even missing one or two doses a week can reduce the chance of success, especially when first starting treatment.
Taking medication exactly on time is very important. However, there is usually a window period of about an hour that is still okay. Some drugs and some people have a wider window period than others.
Because of this variation it is better to aim for the same time each day.
Diet restrictions are very important. Ignoring these can be like only taking half a dose. You will not absorb enough of the drug for it to work properly. Resistance is then more likely.
Part of the reason I started combination therapy was hearing the experiences of other people living with HIV and seeing how well they looked. I have been on HIV treatment ever since, without a break.
The biggest challenge for me to being adherent is the travel involved in the work and for holidays.
Once or twice I have mistakenly taken my efavirenz during the day instead of at night. I have barely been able to function because of the side effects.
I now facilitate treatment workshops with African people in the UK. People want to know more about their treatments and want to learn. One person came up to me and said that they always tried to adhere to HIV treatment but didn’t know why they had to.
Learning the reasons why they need to be adherent was an eye opener for them and they were then able to confidently tell others the same things.
— Winnie, London