UNDERSTANDING ARV ADHERENCE

Key Points

• Treatment adherence includes starting HIV treatment, keeping all medical appointments, and taking HIV medicines every day and exactly as prescribed (also called medication adherence). For people with HIV, treatment adherence is key to staying healthy.

• It's best to see a health care provider as soon as possible after testing positive for HIV. Once in medical care, people with HIV should start taking HIV medicines as soon as possible.

• Because HIV requires lifelong treatment, it's important for people with HIV to regularly visit their health care provider. Ongoing medical care includes monitoring to make sure a person's HIV regimen is keeping the virus under control.

What is HIV treatment adherence?

For people with HIV, treatment adherence means:

• Starting HIV treatment

• Keeping all medical appointments

• Taking HIV medicines every day and exactly as prescribed (also called medication adherence)

Adherence to treatment is a key part of staying healthy with HIV.

How soon should a person start treatment after testing positive for HIV?

It's best to see a health care provider as soon as possible after testing positive for HIV. Once in medical care, people with HIV should start taking HIV medicines as soon as possible. Treatment with HIV medicines (called antiretroviral therapy or ART) is recommended for everyone with HIV. HIV medicines help people with HIV live longer, healthier lives. HIV medicines also reduce the risk of HIV transmission.

Because HIV requires lifelong treatment, it's important for people with HIV to regularly visit their health care provider. Ongoing medical care includes monitoring to make sure a person's HIV regimen is keeping the virus under control. During regular medical appointments, health care providers can also recommend resources to help people deal with any issues that may interfere with medication adherence.

Why is medication adherence important?

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 resistance and HIV treatment failure.

Poor adherence to an HIV regimen also allows HIV to destroy the immune system. A damaged immune system makes it hard for the body to fight off infections.

Taking your HIV medication daily as prescribed provides many benefits. Among them, it:

• Allows the HIV medication to reduce the amount of HIV in your body (also called the viral load) to a very low level. This is called viral suppression. If the viral load is so low that it doesn’t show up in a standard lab test, this is called having an undetectable viral load. Getting and keeping an undetectable viral load is the best thing you can do to stay healthy.

• Helps protect your partners. If you take HIV medication every day, exactly as prescribed and get and keep an undetectable viral load, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex. This is called Treatment as Prevention

Taking your HIV medication daily is also important because skipping doses makes it easier for HIV to change form, causing your medication to stop working. This is called drug resistance. HIV can become resistant to your medication and to similar medications that you have not yet taken. This limits your options for successful HIV treatment. Drug-resistant strains of HIV can be transmitted to others, too.

Taking your HIV medication every day, exactly the way your health care provider tells you to will help keep your viral load low and your CD4 cell count high. If you skip doses, even now and then, you are giving HIV the chance to multiply rapidly. This could weaken your immune system, and you could become sick.

Talk to your health care provider if you miss a dose. In most cases, if you realize you missed a dose, take the medicines as soon as you can, then take the next dose at your usual scheduled time (unless your pharmacist or health care provider has told you something different).

If you find you miss a lot of doses, talk to your health care provider or pharmacist about ways to help you remember your medicines. You and your health care provider may even decide to change your treatment regimen to fit your health care needs and life situation, which may change over time.

Yes, antiretroviral therapy (ART) reduces your viral load, ideally to an undetectable level. If your viral load goes down after starting ART, then the treatment is working, and you should continue to take your medicine as prescribed. If you keep an undetectable viral load, you can stay healthy and have effectively no risk of transmitting HIV to an HIV-negative partner through sex.