HIV Update: Adherence 4 Life

By Kevin Osborne (IPPF)

Taking any routine medication on a regular basis is challenging for us all. More so if the regimen is life-saving and adhering to it requires a life-long commitment. With antiretroviral treatment (ART) reaching more people than ever, many more are now facing this challenge. As the world recognizes both World AIDS Day (1 December) and International Human Rights Day (10 December), it is important to ensure that our programmes are improving and maintaining the health and well-being of people living with HIV, including support for treatment adherence.

As treatment reduces a person’s viral load, it also reduces the risk of onward HIV transmission. This evidence shows that treatment should be part of a combination prevention strategy or ‘treatment as prevention’ approach. Starting treatment earlier means that viral load can be reduced earlier and this, in turn, can help to avert a significant number of new HIV infections. This is one aspect of the new ‘Treatment 2.0’ platform introduced by WHO and UNAIDS.

In 2010, WHO introduced updated guidelines promoting the earlier initiation of treatment, adding an estimated five million people who are now eligible for treatment. With more people receiving treatment, there is growing emphasis on issues such as treatment retention and resistance. Once treatment is no longer effective, it may be necessary to move to second- or third-lines of treatment – a luxury still not widely available in many low- and middle-income countries.

However, reflections by Dr. Ashraf Grimwood – CEO of Kheth'Impilo and a leading HIV clinician in South Africa for many years – indicates that adherence is more than just about taking pills. While scientists develop new treatment options to improve the effectiveness and ease of use, IPPF needs to provide further support to people living with HIV – in ways big and small – to help increase overall treatment adherence rates. From supplying pill boxes and promoting individual adherence, to scaling-up community-based support services and providing adherence counselling and peer support – a variety of interventions will help to realize the promise of treatment and treatment-centred HIV prevention.

Article from IPPF HIV Update newsletter - Issue 24: http://www.ippf.org/en/Resources/Newsletters/HIV+Update+Issue+24.htm