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Factors affecting adherence and you
Everyone’s adherence to medication can go through difficult periods. These are some of the things which might affect your adherence to HIV medication.
Being involved in treatment decisions
The best time to start HAART still is not known. However, if you are motivated to take your treatment and have been involved in reaching a decision about when to start and what medication to start with, you may be more likely to adhere well. Similarly, if you understand why you need to take medication and the benefits of treatment, and how these outweigh the risk of side-effects, you are also more likely to adhere.
Depression and mental health problems
Mental health problems such as depression are linked with low levels of adherence. If you are living with depression and do not feel that you are able to start an anti-HIV treatment regimen and adhere to it properly, then it might be best to wait until you feel more able to cope. Similarly, if you think that depression is having an effect on your adherence, it is important to seek help and treatment for the depression. Depression in people with HIV is common and many HIV treatment centres have specialist mental health teams. Treatments for depression work just as well in people with HIV.
For more information see the booklet HIV and mental health in this series.
Lack of money and housing problems
Lack of money, poor housing and feeling isolated and alone may affect your ability to adhere. Not having enough money could mean that you are unable to eat the foods that your prescription requires. Many HIV organisations can provide advice about money and benefits, and your HIV clinic may have a specialist HIV social worker who may also be able to help or refer you to somebody who is able to help.
Support from other people such as friends or family may also help you to take your medication. On the other hand, some people may be worried about other people knowing that they have HIV and may not wish to be seen taking their medication. Family responsibilities may also affect your ability to adhere, as you may feel under pressure to put the health care needs of others before your own (see the section on special issues for pregnant women and for children on page 23).
Being homeless or in poor housing has also been shown to have a negative impact on adherence, as has drug and alcohol use. However, you should not assume that just because you have issues in your life other than HIV, you will not be able to take your medication properly. There is good evidence that receiving adherence support from your clinic and other HIV support organisations can help you to improve your adherence, even if you are living in the most difficult of circumstances.
What you think about your HIV treatment
People who understand why taking HAART could benefit their health are more likely to achieve high levels of adherence.
If you are thinking about stopping medication because you do not think that it is working or you are concerned about side-effects, you should make sure that your thoughts and concerns are realistic. NAM’s other booklets in this series, or introductory Factsheets, could provide a useful starting point. You should also make sure that you discuss any concerns you have about your medication or health with your doctor and you should not stop or alter your medication schedule without first seeking medical advice.