The Key To Success: Adherence

Adherence to HIV treatment is a major, personal, individual decision that anyone who is HIV + has to make. It is a matter of life and death in some cases however many have heard the phrase that it is better to not even start if you aren’t going to adhere than to start and stop. Due to the fact that our bodies can build resistances very quickly, adherence is of the upmost importance. Through the brave efforts of so many that fought and in some cases died throughout the 80’s, in todays day and age we now have access to this life saving option. Throughout the years we have progressed in both the quality of the drugs and the quantity that has to be taken on a daily basis. I remember when I was in sex education in high school watching a video on someone who had been diagnosed with AIDS and the multiple pills (close to 30) that had to be taken on a daily basis. That was an eye opener for me and I remember telling myself I never wanted to contract this virus because I couldn’t imagine having to take so many pills. Though some still have to take multiple pill regimens we have made great strides.

We are very fortunate to live in the time era that we do and be able to live healthy productive lives that seemed like a distant hope in the past. Though the medicine is available it is sadly reported that only 25 % of people who are positive adhere to treatment and follow up with their doctor. Many stop their medications or take “med vacations” stopping use for days or weeks on end thinking that they are doing no harm to themselves. Some stop for valid reasons such as the loss of health insurance however many simply give up due to the side effects. Let me tell you I fought through the side effects of Atripla for over 1 1/2 year putting my body through a living hell every day with the hope that the side effects would diminish, they never did. Over time it got progressively worse to the point where I was dreading have to take my pill every day. Thank God to this day I have never missed one dose since being diagnosed but there were definitely nights where it crossed my mind, just one night please let me feel normal for once. Despite the bombardment of these side effects I was determined not to give up. Instead I went and talked to my doctor about switching medicines which I was able to.

I switched to Complera which has been the difference between night and day for me. I have very minimal side effects and go for my lab results here in a couple of weeks to verify my numbers are still good and I am having no toxic side effects. The point is that I did not just throw in the towel and say hey I can’t do this. Life is too precious for me to do that and I love myself too much to do that. It is mind boggling to me that someone can start treatment, be educated about how deadly this disease can be without meds, and still make the decision to simply not take them exactly how prescribed. There are many factors of why people do not adhere to medicine including

1. Simply forgetting to take them

2. Fear of side effects

3. Fear that someone who does not know there status will see them taking the medicine and find out they are HIV +

4. Alcohol/Drug Abuse (Simply to inebriated to remember)

5. Sleeping through when they are supposed to take dose

When we examine all of these reasons for failing to adhere it is obvious that much of this can be avoided. Here are some suggestions in regards to the above said “reasons” aka “excuses” for not taking our meds.

1. Set a timer every single day when you are supposed to take them. Always make sure you have extra medicine either with you or somewhere you can get to it in case you forget to bring it with you.

2. If you are having problem with side effects speak with your doctor about what you can do about it. Don’t go and change meds over any little side effect, any medicine will have something that comes along with it, but figure out what you can and cannot tolerate. If the problems persist and are debilitating enough then again consult your physician about what other options might be out there for you.

3. I doubt anyone is really going to ask you what pill you are taking and what it is for. If you do fear this then keep it in a pill box along with whatever other medicine you take and take it in private i.e. a restroom, bedroom, laundry room ext….

4. If you are HIV + you should not be drinking or using drugs anyways but I am not here to be the judge of anyone. The best advice is to avoid drugs/alcohol within the hours before taking your medicine that way you do not forget. Always stay in communication with your doctor about your use as some of these substances could interact with your treatment.

5. Taking your meds should be very important to you as even one missed dose can cause resistance to build. Is it very likely that one will dose will do that, no, however why take that chance ? HIV replicates very quickly. If you are a person that likes to sleep a lot then I again would suggest the timer and if you are a real deep sleeper set multiple alarms/reminders so you are sure to be awake.

Adhering to our meds is a constant reminder that we are positive. It for some people, is the hardest part of the day because we can go all day forgetting we have this virus but when we take that one/multiple pill(s) then we remember our condition. Medicine is expensive for varying reasons however in many countries there are drug assistance programs set up in order to help people pay for the medicine. In some countries medicine is even provided for free to its citizens so money should never be an issue. Whatever the cost of the medicine that should never be a factor, how much is your life truly worth?

We are human beings and by nature are prone to make mistakes once in awhile. It is important that we don’t make mistakes when it comes to our meds because that can cause resistances and begin to limit our options of what treatment is available to us. There are only so many HIV medicines out there and if we continue in a pattern of not taking our medicine then pretty soon none of them will work and it’s like we are putting ourself back in the 1980’s. The doctors can’t do much for us without the meds except manage the OI’s as they come along but rather than put ourself in that position then we should always adhere.

You have to be ready to adhere to medicine, it is not always easy, but very necessary. If you are not going to adhere than don’t even try starting because you would rather start out with a clean slate and have all the options available to you as possible. It is an alarming percentage that properly adhere to medicine including taking on a regular basis and exactly as prescribed by the doctor. To me it is very sad to see because we are so fortunate to be in the position we are. I was born in 1990 and didn’t have to live through the 80’s to see the deadly effects AIDS had in the USA. I have plenty of friends who lost numerous family/friends as well as have viewed countless documentaries on this time era when people were wishing with every bone in their body something was available to save them. We can’t be so ignorant now that we have it and fall back into the mind set that HIV is no big deal. It is a major deal and we should never forget that.

Adherence is the key to our success and if we want to live we need to continue taking them, one pill at a time <3. It is a daily struggle but there are many people like myself and many others here to support each other. As always stay healthy and optimistic. There is always hope even while being Poz.

Until Next Time


Joshua D Middleton


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