Prepared by: Bratislav Prokić, August 2022
Review: Dr. Jovana Milić,
Metabolic clinic for HIV in Modena, Italy
What is adherence?
Adherence means compliance with the recommended treatment regimen. In a broader sense, adherence means adhering to recommendations on taking therapy, changing lifestyle habits (healthy diet, physical activity, safer sex, visiting a psychologist, etc.)
What does it mean to be adherent to HIV therapy?
Adherent to HIV therapy means being committed to taking the prescribed amount of medication at the same time (one to two hours up or down), with food or on an empty stomach (if the medication requires it), while checking for interactions with other medications, nutritional supplements, herbal preparations, or drugs.
Which medicines are taken with food?
Medicines that are better absorbed when taken with food (and are currently available in Serbia): tenofovir DF, rilpavirin and darunavir/cobicistat. It is not mandatory to take tenofovir DF (Viread®, Gilestra®, Truvada®, Gilestra duo®) with a meal, but it is mandatory for rilpavirine (Eviplera®), which is taken with a meal. Darunavir/cobicistat (Rezolsta®) is taken with a meal or half an hour after it.
More about dietary requirements for individual HIV medicines
Does it matter if you skip a few doses of HIV medication?
The best treatment results are achieved if the doses are not skipped. The goal is to create a habit of taking the therapy at the same time every day. If all or nearly all doses are regularly taken at the same time and in the correct manner, skipping one or two doses will not be a problem. Things can go wrong if multiple doses are skipped a month.
What can happen if several doses of HIV medication are missed?
Studies show that skipping doses increases the number of viral copies in the blood, which affects the decrease in the number of CD4+ T cells and increases the risk of resistance to drugs, as well as of the transmission of HIV infection to sexual partners (if condoms and pre-exposure prophylaxis (PrEP) are not used). Then it is necessary to change therapy and get used to new drugs.
What should I do if I forget to take my HIV treatment?
The safest option is to take a dose as soon as you realize you missed it and then go back to your regular schedule. If you realize you have missed a dose when you are about to take the next one, wait and take your dose as scheduled. Do not double the dose.
What to do if skipping doses of HIV drugs happens often?
If the therapy is often skipped or delayed, a doctor should be contacted in order to check for possible resistance, change the existing therapy to drugs that have a lower risk of resistance, and seek advice on taking the therapy regularly. Support for regular therapy is provided by counselors and psychologists of the Potent organization.
More on tips for taking therapy regularly
What to do if vomiting occurs after taking HIV medication?
A new dose of antiretroviral therapy should be taken if vomiting occurs less than two hours after ingestion (less than four hours in the case of Eviplera), as well as if parts of the drug are visible in the contents you vomited.
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