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HIV Treatment

HIV Medication Adherence

(Last updated 5/6/2014; last reviewed 5/6/2014)

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Key Points

  • Medication adherence means sticking firmly to an HIV regimen—taking HIV medicines every day and exactly as prescribed.   
  • Adherence to an HIV regimen gives HIV medicines the chance to do their job. HIV medicines prevent HIV from multiplying, which protects the immune system and reduces the risk of drug resistance.
  • Adherence can be difficult for many reasons. For example, side effects from HIV medicines can make it hard to stick to an HIV regimen.
  • To get tips on medication adherence, read this AIDSinfo fact sheet: Following an HIV Regimen: Steps to Take Before and After Starting HIV Medicines.

What is medication adherence?

Adherence means “to stick firmly.” So for people with HIV, medication adherence means sticking firmly to an HIV regimen—taking HIV medicines every day and exactly as prescribed.

Why is adherence to an HIV regimen important?

Adherence to an HIV regimen gives HIV medicines the chance to do their job: to prevent HIV from multiplying and destroying the immune system.

Poor adherence to an HIV regimen allows HIV to destroy the immune system. A damaged immune system makes it hard for the body to fight off infections and certain cancers. Poor adherence also increases the risk of drug resistance.

What is drug resistance?

Drug resistance is when HIV is no longer suppressed by HIV medicines that previously prevented the virus from multiplying.

Drug resistance can develop as HIV multiplies in the body. When HIV multiplies, the virus sometimes mutates (changes form) and makes variations of itself. Variations of HIV that develop while a person is taking HIV medicines can lead to new, drug-resistant strains of HIV. The drug-resistant HIV no longer responds to the HIV medicines that used to suppress the person’s HIV. In other words, the person’s HIV continues to multiply.

Once drug-resistant HIV develops, it remains in the body. Drug resistance limits the number of HIV medicines available to include in a current or future HIV regimen.

What is the connection between medication adherence and drug resistance?

Taking HIV medicines every day prevents HIV from multiplying, which reduces the risk that HIV will mutate and produce drug-resistant HIV. Skipping HIV medicines allows HIV to multiply, which increases the risk of drug-resistant HIV developing.

Research shows that a person’s first HIV regimen offers the best chance for long-term treatment success. So adherence is important from the start—when a person first begins taking HIV medicines.

Why is medication adherence sometimes difficult?

Adherence to an HIV regimen can be difficult for several reasons. For example, side effects from HIV medicines, such as nausea or diarrhea, can make it hard to follow an HIV regimen. A complicated regimen that involves taking several pills at different times every day can also be hard to follow.

The following is a list of other factors that can make medication adherence difficult:

  • Interactions between HIV medicines and other medicines a person may take
  • Trouble swallowing pills or other difficulty taking medicines
  • A busy schedule, shift work, or travel away from home that makes it hard to take pills on time
  • Illness or depression
  • Alcohol or drug use that interferes with the activities of daily life
  • Fear of disclosing one’s HIV-positive status to others  
  • Lack of health insurance to pay for HIV medicines

 

Planning ahead can help. For example, it helps to have a plan in place to manage any issues that can make adherence difficult.

To get tips on adherence, read the AIDSinfo fact sheet: Following an HIV Regimen: Steps to Take Before and After Starting Treatment.

This fact sheet is based on information from the following sources.

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