Adherence Considerations
Life’s unpredictability can challenge your patients’ adherence to the continuum of care1
Building a trusting environment for the people you treat can help you learn about specific adherence challenges they may face, which can include:
Personal, Behavioral,
Medical & Structural
Barriers1
eg, stigma, substance
abuse, lack of transportation
Clinical Barriers1
eg, appointment
scheduling difficulties,
limited clinical hours
System Barriers1
eg, co-pays, prior
approvals
When making HIV treatment decisions, DHHS guidelines recommend considering key factors that affect adherence, including1:
- A person's daily schedule
- Tolerance of pill number, size, and frequency
- Any issues affecting absorption (eg, use of acid-reducing therapy, food requirements)
According
to the DHHS Guidelines
- People with HIV who have ART adherence challenges should be placed on regimens with high genetic barriers to resistance.* Side effects, out-of-pocket costs, convenience, and individual preferences should also be considered.1
- *Please see DHHS guidelines for specific recommended antiretrovirals.
Continue to counsel your patients to take treatment as prescribed.2
Since people in your care may shift back and forth on the care continuum, it's important to recognize that adherence should be a collaborative effort between you and your patients.1
Some strategies to help set people with HIV up for improved adherence, can include1:
According
to the DHHS Guidelines
- People with HIV who have difficulties with adherence to appointments or ART should be provided additional adherence support using a constructive, collaborative, nonjudgmental, and problem-solving approach.1
Continue to counsel your patients to take their medication as prescribed.2
ART, antiretroviral therapy; DHHS, US Department of Health and Human Services.
References:
1. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. Department of Health and Human Services. Updated September 12, 2024. Accessed September 24, 2024. https://clinicalinfo.hiv.gov/