AIDS and HIV: Adherence to Medications in Persons with HIV Infection

Judith A. Erlen & Mary Pat Mellors & E. Sue Lehman-Trzynka

Antiretroviral therapy is dramatically changing the course of HIV infection by influencing the medical management and health outcomes of persons with HIV infection (PWHIV). While this therapy has brought an increased sense of optimism and hope for PWHIV, it requires patients to be highly committed and strictly adhere to the therapeutic regimen. Adherence rates as high as 95% may be necessary (Paterson et al., 2000). In addition, there is a need for close monitoring of viral load (HIV RNA) and CD4 T-cell counts to assess the effectiveness of the therapy (Andrews & Friedland, 2000). Investigators have demonstrated that lapses in antiretroviral adherence (missed doses) lower the likelihood of suppressing viremia below detectable levels (Paterson et al., 2000). HIV is a retrovirus characterized by the presence of an enzyme, viral reverse transcriptase. This enzyme gives retroviruses the unique ability to synthesize DNA using an RNA template. The viral DNA is subsequently ...

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