Daily intake and therapy compliance

To ensure that your HIV treatment will be effective and to prevent your HIV from becoming resistant to your HIV medications, it is important that you take those medications at approximately the same time(s) every day. Following the instructions in this way is known as complying with your therapy or simply: “therapy compliance”. If you often find it hard to stick to your pill-taking schedule, discuss that with your doctor or HIV nurse.

Therapy compliance

Therapy compliance means:

  • Never forgetting to take a dose of your medications
  • If you take more than one pill each day: make sure you take the right pillsat the right times
  • Taking your pills on time
  • With certain HIV medications: taking your pills according to the relevant dietary restrictions (either on an empty stomach or with something to eat)

It is important that your pill-taking schedule fits in with your daily life as well as possible. That is the only way you will be able to comply with your therapy.

Have you forgotten to take your medication?

The general rule is: if you have forgotten to take your pill(s), take them as soon as possible. Afterwards you can return to your normal pill-taking schedule. If you only realise that you have forgotten to take your pills shortly before your next pill-taking moment, then just take them at the normal time. NEVER take a double dose.

To be sure, ask your doctor if this general rule also holds for your medications.

Vomiting and your HIV medications

It could happen that you will need to throw up shortly after you have taken your pills. In that case, take another set. If you have taken a pill on an empty stomach and you vomit an hour later, you don't need to retake your pill. The pill will already have gone through your stomach by then. If you took a pill together with food and you only vomit three hours later, you also won't need to retake your medication.

Take your medication on time every day

HIV medications will only work properly if there is enough of them in your body at any given time. If that is not the case, the virus will not be properly inhibited and your viral load will rise again. If that happens, the virus could become resistant.

Resistance to HIV medication

Resistance develops because the replication of HIV is a sloppy process. Mutations can take place, such that the newly replicated virus will be slightly different than the previous one. In that way, a virus can develop that your HIV medications will no longer be able to fight. And that virus will then be able to replicate itself with nothing to stop it.

By taking your pills on time every day, the amount of HIV medications in your blood will remain constant and they will effectively stop your HIV from replicating. That way, the virus also won't have a chance to reproduce itself in a “sloppy” way and develop resistance against your medications.

Switching medications due to resistance

If resistance does develop, you can switch medications, although you can't keep switching indefinitely. Here's why: HIV medications are divided into different types or “classes”. Medications that belong to the same class work in more or less the same way. If your HIV becomes resistant to a medication from a particular class, there is a chance that it will also be resistant to other medications from that same class. This is known as “cross resistance”. Although there are many different HIV medications to choose from, cross resistance will significantly reduce the number of options you have.   

Motivation for treatment

It is important that you are motivated to start treatment. Ask yourself a few questions in advance:

  • Do the advantages of treatment outweigh the disadvantages?
  • Are there friends or family members who can offer you practical support in the beginning? For example by reminding you when it's time for you to take your pills? 
  • In which situations do you think you might find it difficult to take your medications? Prepare yourself for those situations. Think of tricks to help you take your medications on time, every time.

Other tips:

  • Link your pill-taking to other things that you do around the same time each day. For example, take your medications while you are watching the 8 o'clock news every evening.
  • If you don't have such a strong daily routine, set the alarm function on your watch or cell phone. There are also special pill-time alarm clocks.
  • Set your medications in a place where you can clearly see them and where you want to be when you take them, for example by the bathroom sink or on the breakfast table.
  • Keep a reserve dose in as many strategic places as possible (e.g. in a drawer of your desk at work, in the glove compartment of your car, in your coat pocket or bag). That way you will have one handy in case you have forgotten to take your medications. You might also keep something to eat and drink in those same places.
  • If you travel to distant countries, keep in mind that you may end up in a different time zone.  This means that that you will need to take your medications at a different time of day.  You can also shift your pill-taking times to a different time of day for the rest of your stay if that is more convenient. Discuss with your HIV nurse how you can best do that.  

If you often find it hard to stick to your pill-taking schedule – for example because your use of alcohol or drugs sometimes leads you to forget to take your medications – bring that up with your doctor or HIV nurse. They may be able to help you find a combination therapy that will better match your situation. Identifying and discussing problems before it's too late is better than adjusting your pill-taking schedule on your own or even stopping with your treatment altogether. You can always call the Servicepunt (service centre) of Hiv Vereniging Nederland. They can also give you advice.



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