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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”


Medication Adherence Among HIV-Positive Women

Monthly Summaries of Nursing Research

from Medscape Nurses

Durante AJ, Bova CA, Fennie KP, et al. Home-based study of anti-HIV drug regimen adherence among HIV-infected women: feasibility and preliminary results. AIDS Care. 2003;15:103-115.

For HIV-positive patients, effective therapy often requires complex dosing regimens involving combinations of antiretroviral medications to suppress viral replication, delay disease progression, and prolong survival. However, poor compliance with this medication regimen can lead to incomplete viral suppression and the development of drug-resistant strains. Researchers conducted in-home interviews with 63 HIV-positive women to assess medication compliance. Almost half of the women in the sample were 40-49 years of age; 62% were African American, 29% were white, and 5% were Latina; 70% were high school graduates; and most reported a history of drug and alcohol use. Most had visited their HIV clinic within the last 3 months, but 30% did not know their most recent CD4 T-cell count, and 34% did not know their most recent viral load result. For their HIV treatment, 77% were on a highly active antiretroviral therapy (HAART) regimen involving 3 or more medications. By recall over the previous 3 days, 67% reported taking all of their prescribed medications, while 11% took less than half. Reasons given by women who missed doses included forgetting about the dose; being away from home, busy, or asleep; running out of medication; wanting to avoid side effects; and feeling well enough not to "need" the medicine. More than 80% of adherent women understood that their medications were supposed to reduce viral load, compared with 47% of nonadherent women. However, only about half in both groups understood the effect their medication should have on CD4 T-cell counts. Interventions to improve adherence to treatment for HIV-positive patients need to focus on education about medication effects and building medication schedules into the daily routine.