Side effects and adherence

Adherence is the term that describes taking the medications in your combination exactly as they are prescribed – on time and following any dietary advice.

The importance of adherence

Man with a headache Whether you are starting your first treatment or have been using HIV drugs for a long time, your doctor should have talked to you about the importance of adherence.

This is the term that describes taking the medications exactly as they are prescribed. This includes taking them on time and following any dietary advice. It also means taking them on weekdays, at weekends and when you are away on holiday.

Numerous studies show that NOT getting adherence right will lead to early treatment failure. There have also been studies that look at the relationship between adherence and side effects.

One of these studies looked at side effects over the first month on a new treatment.

People who reported higher numbers of side effects after the first month of treatment were less adherent and had lower viral load reductions three months later.

This study provided a more realistic picture than is generally recognised of the real effect of side effects on everyday life. Ninety-four percent of people reported at least one symptom after 4 weeks, which dropped slightly to 88% after 3 months.

Feeling more tired and having diarrhoea were the most frequently reported side effects, 40% of which were mild and 7% were severe.

...94% of people reported at least one symptom after 4 weeks... If you are getting side effects, they need to be taken seriously, as early as possible by both you and your clinic...

People reported an average of four side effects after four weeks, which dropped to an average of three at 16 weeks. And importantly, the severity of these side effects reduced over this time.

This study was run a few years ago, and todays treatments are much more tolerable. Nevertheless, the conclusion was clear. If you are getting side effects, they need to be taken seriously, and as early as possible by both you and your clinic.

There are many treatments that help with nausea and diarrhoea. You can be given a small supply of these to take to prevent side effects when you first start treatment. You should also be able to collect these easily from your clinic as soon as you get symptoms.

Adherence can be more difficult when medications make you feel less well. Some of the longer-term side effects like lipodystrophy, may also reduce adherence.

If you have lipodystrophy and it is affecting your self confidence, your social life and how you feel about yourself it is important to discuss this with your doctor.