Treatment adherence (sometimes called “compliance”) means taking the correct dose of your medications every time, exactly as prescribed by your health care provider or recommended by your pharmacist. To successfully halt HIV replication and keep viral load suppressed, antiretroviral medications must be maintained at high enough levels in the body, all day, every day. If drug levels fall too low, the virus can resume its replication, which can lead to disease progression and increase the risk of HIV transmission. People who maintain an undetectable viral load do not transmit HIV through sex (Undetectable = Untransmittable). In addition, poor adherence can result in drug resistance, which can cause your meds to stop working and may limit your future treatment options.
Certain factors have been found to affect adherence:
Attitude: People who feel strongly that they are benefitting from their medications have an easier time adhering to treatment. Understanding how and why the drugs work can help with adherence.
Mood: People who are depressed may have a harder time adhering to treatment. If you suspect you are experiencing depression, talk to your health care provider.
Side effects: Concerns about side effects can make people reluctant to stick to their treatment. If you’re experiencing adverse effects, talk to your health care provider.
Cost of treatment: If you’re having trouble affording your medications, you may be tempted to take them less often in an effort to stretch your prescription. Talk to your doctor or case manager about health insurance options and payment assistance programs.
Being a caregiver: The needs and concerns of the people you care for, including children, can become your primary focus. Remember that your health is important: You can’t care for others if you don’t take care of yourself.
Disorder: The amount of disorder in your life, and the stress it creates, can lead to adherence problems. An unpredictable or overwhelming schedule, unstable living situation or overuse of alcohol or drugs can negatively affect adherence. Try to identify and reduce the disorder in your life—your health care provider or case manager may be able to help.
When starting treatment for the first time or switching to a new regimen, you may want to evaluate your lifestyle to see whether there are any potential obstacles to good adherence. Here is a list of questions to consider when making treatment decisions with your health care provider:
- Does your daily schedule change a lot?
- What is your typical eating schedule each day?
- Are you taking other medications?
- What side effects can you tolerate?
- Can you afford your medications
- What should you do if you miss a dose?
Many modern antiretroviral regimens require just one pill once daily. Some have few or no requirements to take them with or without food. If you’re using a combination that requires multiple pills or more frequent doing, ask your health care provider if a simpler regimen might be right for you. In addition, certain medications are more “forgiving” if you occasionally miss a dose.
Most HIV medications must be taken every day, but the new long-acting regimen Cabenuva (injectable cabotegravir plus rilpivirine) is taken just once monthly. However, you will need to visit a clinic every month to have a health care provider administer the shots.
How can I improve adherence?
Here are some tips to help you take your HIV medications on schedule.
- Keep your meds next to something you use regularly. Having your meds near your coffeepot or toothbrush can help remind you to take them daily.
- Beware of schedule changes. Some people have more trouble remembering to take their medications on days off from work or school, during vacations or at other times when their schedule is different from usual.
- Sign up for a reminder. Some AIDS service organizations and pharmacies have free programs that will call or text to remind you to take your medications. There are also reminder services online that will send you a message at a specified time.
- Program your phone. Set an alarm on your phone or watch for the times of day when you need to take medications.
- Ask for help. Ask a friend or family member to remind you to take your meds on schedule.
- Organize your meds. One-week, two-week and one-month pillboxes are available to help you organize your meds in advance.
- Meds on the go. If you need to take your medications while outside the house, check out portable pocket-sized pill cases. Some even have built-in timers.
- Travel with extra doses. Travel with your meds in your carry-on luggage, and bring a few extra doses in case of flight delays, cancellations or other unexpected events.
- Plan ahead. Make sure to regularly refill your prescriptions so you don’t run out of your medications.
Lapses in treatment adherence can happen to anyone. Don’t feel bad or guilty if you sometimes miss a dose, but resolve to do better for the sake of your health. Talk to your health care provider, pharmacist or case manager if you have trouble taking your medications as prescribed and need help addressing adherence challenges. Finding other people in your situation can also help. Join a support group or connect with other people living with HIV in the POZ Forums.
Last Reviewed: December 27, 2021