Adhering to complex regimens for HIV.

Medical literature and clinical reports document that adherence is low among HIV patients and, although not clinically proven, adherence is seen as playing a central role in determining the effectiveness of antiviral therapy. Communication with patients about the reasons for and benefits of therapy ensure a greater chance of commitment to therapy. Memory lapses due to HIV, neurocognitive deficiencies, substance abuse, and psychological disorders are cited as barriers to patients managing their treatment regimens. Rather than only considering the effects of the treatment, physicians need to consider the complexity of therapy, the patient's intrinsic belief in its value, and the patient's lifestyle and ability to take medications as prescribed. Long-term maintenance of a therapy routine is also a concern. To encourage adherence, several techniques are helpful including: using candy to simulate medication, writing schedules or keeping diaries, associating pill-taking with other activities, using timing devices as reminders, and utilizing friends or drug hotlines. Until more is known about specific effects of adherence on viral suppression, it is important to give schedules that are appropriate for the patient.