Why adherence is so important
What is adherence?
Adherence is a word used to describe taking your drugs exactly as prescribed. This includes:
- Taking your meds at the right time.
- Following advice to take with or without food.
- Avoiding any drug interactions.
Adherence is the most important thing you have to think about when you start treatment.
It will make sure that all the drugs in your combination are at high enough levels to control HIV for 24 hours a day, 7 days a week. If these levels drop too low there is a risk of drug resistance.
Sometimes adherence can be difficult. You may need some support to get used to the changes treatment makes in your life. A routine or daily schedule can really help.
- Pick a time to start treatment when you have a few unstressed days to adjust to the changes.
- During the first few weeks, getting your treatment right should be your only priority.
- Some clinics and/or HIV organisations have someone who can help. This can include HIV positive people working as a peer mentor.
How much is enough?
Aiming to take every dose – or almost 100% – is still the best goal. This is because getting into a good habit early will mean you miss less doses in the long run. The structure of a fixed routine will help.
However, nearly everyone will miss an odd dose, and this is okay.
And once your viral load becomes undetectable there is more flexibility. For example, after being undetectable for a few months, even missing a dose completely will also be okay.
So long you only miss doses once or twice a month things should be okay. But if you are missing more than one dose every week or two, please talk to your doctor.
There is also a window period for the timing of your meds. So long as you are generally within an hour or two either side of your usual time that will be okay, even when starting.
The big message though is that it is important to take adherence seriously.
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 run 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
Last updated: 1 June 2022.