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Adherence means taking your HIV treatment correctly. This means every day, the right dose, at the right time, and following the instructions about taking it with or without food. 

If you do not take your medication correctly, the level of HIV in your blood may increase and the treatment may stop working.  

Regular blood tests will show if your treatment is working. They will measure the level of HIV in your blood (viral load) and the strength of your immune system (CD4 count).  

How often do I need to take my treatment?

HIV treatment must be taken every day for life. Antiretroviral drugs (also called antiretrovirals or ARVs) keep HIV under control, but they don’t stay in your body for a long time, so you must keep topping them up every day. Most antiretroviral drugs are taken once a day. Some drugs are taken twice a day.  

What time of day should I take my treatment?

Your healthcare provider will talk to you about the best time of day to take your treatment. If they say to take it in the morning, you might want to take it at breakfast time for example. 

Why does it have to be the same time every day?

Taking your medication at the same time each day makes your treatment most effective. It means there is enough medication in your body throughout the day to stop HIV from making copies of itself and to keep you healthy.  

Should I take my treatment with or without food?

This depends on which antiretroviral drugs you take. Speak to your healthcare provider or read the medication instructions to find out if your drugs need to be taken with food or not. 

What if I forget to take my treatment?

We all forget to take one or two pills from time to time. Take the missed dose when you realise and then take the next dose at your usual time. If you don’t realise that you forgot a dose until it’s time for the next one, don’t take a double dose, just take one. If you are missing doses regularly, speak to your healthcare provider who will be able to help you adhere to your treatment. 

What happens if I stop taking my treatment?

Your viral load will go up. This means HIV can damage your immune system, and that you are more likely to pass HIV on. If you regularly miss doses, there is a risk that the HIV in your body will become resistant to the medication and the drugs will no longer work.  

What will help me adhere to my HIV treatment?

  1. Choose a convenient time to take your treatment every day. 

  1. Mark it on a calendar on your wall or refrigerator so you will be reminded. 

  1. Set an alarm at that time. 

  1. If you have a mobile phone, download an app that will remind you. 

  1. Get a weekly pill box to help keep track of whether you took your medicine each day. 

  1. Carry extra pills when you go out in case you cannot get home on time.  

  1. Plan your daily or weekly timetable to think through where you will be when you need to take your pills. This is particularly helpful when there is a change to your normal routine, e.g., staying away from home.  

  1. Keep your prescription in a safe place or on your phone for when you collect your next refills. 

  1. Make a note of when you need to get your next refills, so you don’t run out. 

  1. Many people find it helpful to get support from people around them like family, friends or clinic staff.  

  1. Talk to your healthcare professional if you are finding it hard to adhere to your treatment.  They can offer support and advice before your treatment stops working. 

Let's talk about adherence!

Here are a few questions to help kick-off discussions on the issues you need to talk about! You can share them on social, on WhatsApp or just get talking.

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Is it OK to take other medication at the same time as HIV treatment?

Some drugs do interact with each other if they are taken at the same time. This means that one or both of them won’t work properly. If you have a co-morbidity, it is important to tell your healthcare provider the names of all the drugs you take, including traditional or herbal medicines and contraceptives. They can then tell you if you can take them at the same time or not.  

What if I am away and forget to bring my HIV treatment?

Call your usual HIV clinic or pharmacy. Explain that you do not have your pills with you. Ask them to send your prescription to a pharmacy near where you currently are so that you can get the right pills as soon as possible. If you can’t call your usual pharmacy, go to a local pharmacy, and ask if they can phone your usual pharmacy for you or access your medical records. 

What if I experience stigma or violence for taking HIV treatment?

Some people may experience stigma or violence from their partner, family, or community for taking treatment. They might tell you not to take it, or they might try and stop you going to get your ARVs. If this happens, remember that taking treatment is the only way to stay healthy with HIV. Speak to a medical professional about getting help to make sure you can still get your ARVs. 

Could my treatment stop working?

For many people, the treatment they start taking will continue to work for as long as they take it.  

If your viral load is not being kept under control, your healthcare professional will find out why. It may be that you are having problems taking the drugs correctly, that they do not interact well with other drugs that you are taking or that your virus has become resistant to them.  

Your healthcare professional will try to help you resolve the problem and stay on the same treatment. However, if your treatment has stopped working, then you will be advised to change treatment. 

How to support others with adherence

If someone you know needs support with adherence, you could: 

  • contact them around the time they should take their pills each day to remind them 

  • set a reminder for when they need to refill their pills, so you can check that they did that 

  • check in before they stay away from home and remind them to pack extra pills 

  • ask them every so often how they are finding taking the pills and if they are getting side effects. 

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