15th International AIDS Conference Bangkok, Thailand - July 11-16, 2004

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10288)

Rodkjaer LR
Skejby Hospital, Aarhus, Denmark

BACKGROUND: Successful treatment of hiv with HAART requires that patient maintain nearly perfect adherence to the prescribed regimen. Suboptimal adherence is clearly the most common cause of virologic failure of HAART regimens. The purpose of the study was to explain how patients living with hiv manage their interacting illness symptoms, medication side effects and treatment adherence choices taking their medication.

METHODS: Patients were interviewed and Grounded Theory methodology was used in order to generate a conceptual explanation of the interplay between symptom management and medication adherence. Semistructured interviews were conducted with ten patients.

RESULTS: The interviews revealed that adherence and non-adherence is complex. The patients went through a kind of process from starting medication until the medication were an integrated part of their lives. The process started with a phase where the patients experienced the change from living as healthy to living as sick. They experienced not having control over their lives because the medication dominated their daily living, but after a period they gained control because they were more familiar with the medicine. How the process went was an individual situation every time with each patient and depended on a lot of factors. Some factors of importance were readiness to start medication, health beliefs, planning, routine and follow-up.

CONCLUSIONS: Adherence is a multidimensional concept and a multifaceted approach to improve adherence is neded. It is essential that providers of care for patients with hiv infection know what problems and barriers the patient is facing, to be able to proactively assist and support their patients efforts to adhere to medication regimens. It is a teamwork and therefore necessary that the multidisciplinary care team work together and develop a method which enhance adherence. One of the key issues is communication.

040711
B10288

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