Treatment adherence means taking the correct dose of your medications every time, exactly as prescribed by your health care provider or recommended by your pharmacist.

To keep viral load suppressed, antiretroviral medications must be maintained at high enough levels. If drug levels fall too low, the virus can resume replication, which can lead to disease progression and increase the risk of HIV transmission. In addition, poor adherence can result in drug resistance, which can cause your meds to stop working and limit your future treatment options.

Several factors can affect adherence, including your attitude and mood. People who feel that they’re benefiting from their medications have an easier time adhering to treatment, while people who experience depression may have more difficulty. People who are concerned about side effects may be reluctant to stick to their treatment, and those who have trouble affording their medications may be tempted to take them less often to stretch their prescriptions. In addition, caregiving responsibilities, an unpredictable or overwhelming schedule, an unstable living situation and overuse of alcohol or drugs can interfere with adherence.

Many modern antiretroviral regimens require just one pill once daily. If you’re using a combination that involves multiple pills or more frequent dosing, ask your doctor whether 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.

When starting treatment for the first time or switching to a new regimen, evaluate your lifestyle for potential obstacles to good adherence. When making treatment decisions with your doctor, discuss your daily schedule, other medications you’re taking, what side effects you can tolerate and what to do if you miss a dose.

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.

Adherence Tips

  1. Keep your medications near something you use regularly, such as your coffeepot or toothbrush.
  2. Beware of schedule changes; some people have trouble remembering to take their meds on days off from work or school or during vacations.
  3. Sign up for a reminder; some AIDS service organizations, pharmacies and websites will call or text to remind you to take your meds.
  4. Set an alarm on your phone or watch for the times of day when you need to take medications.
  5. Ask a friend or family member to remind you to take your meds on schedule.
  6. Organize your medications in a weekly or monthly pill box.
  7. If you need to take your meds while outside the house, check out portable pocket-size pill cases.
  8. Travel with your meds in your carry-on luggage, and bring a few extra doses in case of flight delays or other unexpected events.
  9. Make sure to regularly refill your prescriptions so you don’t run out of your medications.