Adherence describes the ability to take your medication on time and at the right dosage. I understood the meaning, but I skipped too many doses and found my CD4 cell count not far from single digits.
As an African American who has progressed to living a healthy life with HIV, I still have to remind myself of the lessons I learned by being non-adhering. I was never a pill person. Even before my diagnosis, I would have rather rested my body than take an aspirin for my headache. Pills represented a weakness.

I always considered myself a strong person. I wanted to heal without the aid of something made in a lab. So when I was diagnosed with HIV, I knew it was going to be a struggle for me. It was one of the reasons I didn’t commit to seeing a doctor on a regular basis. Since I wasn’t placing myself on pills, what need was there for a doctor.

I knew I was playing with my health, but the idea of swallowing a pill every day for the rest of my life was not appealing. I was only 19 years old when diagnosed, so that meant a long road ahead. I also was concerned about any long-term damage. Would my liver or other organs pay for my decision?

My change in thinking came one year long ago. I was constantly sick. I started that year with bronchitis and ended it with bronchitis. My doctor told me that my CD4 cells were starting to dip below 50 and heading to zero. That’s when the fear set in. In a weird way, it was OK for me to have HIV, as long as I didn’t have an AIDS diagnosis. I had AIDS.

I was defeated. I allowed my doctor to prescribe me HIV meds. Although it was only a square piece of paper that he handed me, it felt like an anvil. I told myself this was my life preserver, which would stop me from sinking further.

The pill kaleidoscope of colors and sizes intimidated me. The instructions were just as puzzling. I didn’t know it was going to be so complicated. Then there was the matter of how to keep the pills hidden if someone visited my home.

My will was tested when the side effects came. People shared stories of nausea, cramps and constant diarrhea, which added to my reluctance. In the scheme of things, I was pretty lucky. I only had loose stool. Eventually that went away and so did my opposition.

I started to feel better. My CD4 cells were inching up, but my doctor still was concerned about why my levels were rising so slowly. When he asked me if I was missing dosages, I looked him in the eye and said no. I lied. The truth was I was taking many “holidays” [breaks from my drug regimen].

My holidays were scattered, taking just the morning dosage, for example, and missing the evening dosage, or vice versa. Some days I wouldn’t take it because I was tired, out late or just didn’t feel like it. My unspoken reason was untreated depression that made adhering unrealistic.

My punishment? I became resistant not only to my medication, but also to others in the same class of HIV meds. My stubbornness was affecting my life badly. I had to get my act together. If medication could help me fight the virus, I should do what I needed to do.

My advice to anyone having issues with inconsistent adherence is to first realize you’re playing with your health. Look at your life and see what’s blocking you. For me, it was depression. Also, talk to your doctor to come up with a treatment regimen that works for you. Since my diagnosis, newer meds have been developed. Some regimens allow people to take just one pill a day.

I’ve since dedicated myself to being adherent, and my reward is seeing my CD4 cells climb. I was close to zero, but now I’m at a healthy 632. That’s a long way from zero. Although I take my meds daily, I still don’t lose sight of my ability to take care of myself. It’s just that I have a little help—and that’s OK.