HIV in Canada: A primer for service providers



Key Points

  • Effective treatment with HIV drugs requires long-term adherence.
  • Poor adherence can lead to resistance and drug treatment failure.

Antiretroviral therapy (ART) has helped to transform HIV into a chronic illness. However, adherence is important to see the benefits of HIV treatment. Adherence is taking HIV treatment everyday as prescribed.

Adherence is critical for the attainment and sustainment of an undetectable viral load. Non-adherence to ART can result in poorer treatment outcomes, including treatment failure, which can lead to greater morbidity (illnesses) and mortality (death). Furthermore, non-adherence can lead to drug resistance, which can reduce future treatment options.

Interventions to improve adherence to ART need to be individualized, multifaceted and repetitive. Frequently-used interventions include individualized dosing instructions with photos of the drugs, drug organizers (e.g., seven-day or even 28-day pill boxes), more frequent follow-up, and special adherence education sessions led by members of the care team (nurses, pharmacists, social workers, community health intermediaries or peer educators). In certain populations, such as people who use drugs, directly observed therapy (DOT) for ART has produced significant improvements in adherence and viral suppression.


Adherence and Resistance

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