Do You Take Your Medications Regularly?

I forgot to take my pills again! How many times have you heard (or said) those words? Depending on what the medication is for, there may be only minimal consequences for missing a dose. But there’s a big difference between an occasional late or missed dose vs. going extended periods. This is so especially true when we are talking about our HIV meds. When we started our drug regimen, most of us recognized that it’s for the rest of our life, barring a cure in the future. Unfortunately, life happens and sometimes things get in the way so our adherence becomes less than it should be.

Usually, if we miss a dose or are late, the advice is to take it as soon as we remember unless it’s almost time to take our next dose. Taking two doses at once is not a good idea.

Challenges in remembering to take HIV medications

If your problem is as simple as mine, many times it boils down to a break in routine that throws me off schedule.  For example, when I’m away from home I tend to lose focus on something as simple as taking my meds because I’m not in my normal routine. As a solution for this, there are various apps available that not only track when we take our meds but send alerts when it’s time to take them.

But sometimes the reasons for missed pills are far more serious. Things such as insufficient funds, lack of access to care, mental health problems like depression, or substance abuse issues may be the problem. All are linked to poor adherence with the prescribed regime of therapy.

Other reasons for nonadherence to HIV medications

According to an article published in 2017 by the US Department of Health and Human Services, only about 55% of adults and 51% of children have their viral loads fully suppressed, meaning they are taking their meds sufficiently to do their job.¹ (These numbers seem to vary by study). This is due not only to the factors listed but other things such as geographic region and even culture. Note that these stats are talking about good old US of A, not a 3rd world region.

Other reasons for non-adherence may be beyond our control, such as illness, accident, or surgery that prevents taking medication orally. Considering the half-lives of most HIV meds ranges greatly, we should avoid prolonged lapses if possible. Even in some of those situations, it may be possible to take our pill with just a sip of water.

Reasons why we should take our medications

Indications are that stopping our medications even for short periods of time can allow our health to begin to deteriorate. This can possibly make the virus more resistant to therapy when we resume. Some studies have been done on what happens when taking planned time off, such as 5 days on, 2 off. In most instances the long term results indicated developing drug resistance, elevated CD4 count and a detectable viral load.

So take your pills!

This article barely touches on some of the more complex issues contributing to non-adherence. In the future, we'll examine some of those in more detail. In the meantime, the moral of the story is to remember our health is a precious thing and we should not take unnecessary risks with it. Take our medications as prescribed and give them and our body a fighting chance.