Adherence to Antiretroviral Therapy
Gerald H. Friedland 1, Laurie A. Andrews 1
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*Correspondence: Gerald H. Friedland, Email not available
Abstract
The impressive and gratifying advances in antiretroviral therapy have benefited many with HIV disease who are fortunate to have access to these complicated and expensive regimens. Adherence to antiretroviral therapy has emerged as a crucial issue in HIV/AIDS therapeutics. No other infectious disease has required life long therapy. Adequate drug potency and favorable pharmacologic properties of antiretroviral agents are essential for obtaining therapeutic benefit, however, the behavioral aspects of proper adherence to medication, often determine therapeutic outcome. Adherence is a complex clinical issue requiring careful and ongoing collaboration between patients and clinicians. In this paper, we discuss evidence illustrating the importance of adherence in determining therapeutic outcome and issues relating to the measurement of adherence and required levels of adherence. We also review determinants associated with excellent and poor adherence, current issues in the development and use of interventions to improve adherence and strategies that clinicians might employ to assist patients in obtaining high levels of adherence. The issue of adherence to antiretroviral therapy illustrates challenges and opportunities in the integration of biology and behavior in the successful care of patients with HIV disease.
