Health & Wellness

AIDS Watch: Bitter Little Pills

Kelly McCann

HIV meds can’t help if they are not taken properly.

by Kelly A. McCann

Since 1987 when AZT received FDA approval as the first treatment for HIV/AIDS, more than 20 highly active antiretroviral medications have come onto the market. This is a significant accomplishment, because the number and variety of HIV drugs provides doctors and patients with treatment options and more effective therapies. That means people infected with HIV can live longer and healthier lives.

That good news, however, is tempered with less encouraging news. Some HIV medications can be accompanied by unpleasant side effects, such as nausea or diarrhea, while others may have specific dosing instructions such as “take with food.” Such issues can make it more difficult for patients to take their medications as prescribed.

Lack of adherence to one’s HIV medication regimen is the biggest obstacle to treatment success. Anti-retroviral medications are designed to block or interfere with the HIV replication process. If a patient misses a dose, the amount of drug in the bloodstream drops below a therapeutic level, allowing copies of the virus to be made. Those copies may even have mutations that can help the virus develop a resistance to the medications. Resistance means the medication no longer helps combat one’s HIV infection.

In order to prevent resistance, and to allow the meds to be most efficacious, patients must take their meds exactly as prescribed. Or at the very least, as some studies have suggested, patients should achieve a 95-percent medication adherence rate in order to get maximum benefit from their therapy. That means missing very few doses.

Despite the importance of medication adherence, many people living with HIV/AIDS have trouble sticking with their treatment regimen. Several studies have been conducted to determine the reasons patients fail to take their meds as prescribed. Study results indicated the most common reasons for missing medication doses were forgetting, sleeping through a dose time, failing to take meds along when away from home, and just being too busy to take medication.

Those are all legitimate reasons for missing a dose of medication, but given the potentially dire consequences of failing to adhere to treatment schedules, patients must do all they can to follow the treatment instructions to the letter.

What can be done to help improve adherence? The first thing to do is identify the barriers you encounter that prevent adherence. Is it your memory? Is it the specific food requirements? Is it the side effects? Once you know what the problem is, there are proven strategies to help you be more successful. Some of the following tips may help:

• Use pill boxes to organize your medication doses in advance.
• Take the pill box with you to work, school, your mama’s house, and everywhere else you go away from home.
• Use an alarm watch or timer to remind you of scheduled doses.
• If confidentiality is an issue, excuse yourself and go take your meds in the restroom or in your car.
• Keep water and snack items at work, in your car, or other places you may regularly spend time.
• Consult your physician about side-effects management.
• Keep recreational drug and alcohol use to a minimum.

For certain patients who are prescribed Kaletra, another option is available to help them achieve greater medication adherence. Launched by Abbott Laboratories in 2008, the Positive Partnership Program (PPP) is a six-month program that gives patients a support resource to help them manage their medications. It provides health information on important topics such as managing side effects, diet and exercise suggestions for people living with HIV, and tips for medication adherence success.

The PPP also helps Kaletra patients obtain their best health outcomes by facilitating a dialogue between them and their doctors. With the patient’s consent, health-care providers are given a written report of self-reported patient feedback regarding their treatment adherence, satisfaction, and life factors that may impact their health care.

If you are HIV-positive and you’ve recently been prescribed Kaletra, you may enroll in the PPP by calling 1-888-458-6442 between the hours of 7 a.m. and 7 p.m. CDT. You’ll be asked for your name, the name of your doctor, and your Kaletra prescription number.

In return, you’ll receive a free HIV health planner that can help you with scheduling appointments and tracking your results. And you may qualify for up to $50 in co-pay savings on each of your Kaletra prescriptions over the next six months!

Whether or not you enroll in PPP or follow the suggested tips to help you take your meds, remember that medication adherence is a daily challenge. If you find that you are not ready to religiously adhere to a medication regimen, consult your physician and consider delaying treatment until you are ready. A strong commitment to medication adherence is the key to treatment success.

Kelly McCann is the chief executive officer of AIDS Foundation Houston, which presents Dining Out for Life on April 29. Read her blog at

Kelly McCann is the CEO of AIDS Foundation Houston. Read her blog at

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