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Adherence tips
Simple forgetfulness is a common reason for missing doses of anti-HIV drugs. If you do forget to take your medication don't be too hard on yourself, but do try to learn from the experience what it was that caused you to forget. If you are missing doses regularly, then discuss this with your doctor. It may be possible to make your schedule easier, or change to a more suitable combination. Where this is not an option, talking through your concerns with your health care team may provide you with the support you need to manage your treatment better.
Practice beforehand
Some people have found that taking practice doses of their potential HAART regimen helps them to adhere to their actual regimen. This might involve taking sweets or multivitamins for a few weeks in the same quantities and at the same time as you will have to do with your HAART regimen, including any dietary restrictions.
Keeping a diary
Confusion over which pills to take when, and what times to eat or avoid food, may be a problem when starting a new combination. To avoid this, your doctor or pharmacist can provide a written daily schedule with your prescription, which you can tick off after taking your dose. Some pharmacists offer stickers for medication containers, which have the same function.
Storing and transporting pills
Partitioned containers that you fill once a week or every few days with the individual daily doses are available. With some versions you can take out a single day's dose, or several if you may be away for some time. Your HIV pharmacist should be able to provide one of these boxes free. Make sure that the box you're getting is big enough and that you have checked with your pharmacist that all your drugs are suitable for storing out of their original container. Some pills deteriorate if not kept correctly. The bottle that indinavir comes in, for instance, contain small canisters that keep the capsules dry and stop them from leaking. You could also use a film container, but the same advice applies.
Some people keep doses in the different places that they could be at the time of pill-taking, e.g. friend's house, handbag, car. Make sure you store medication safely out of the way of children, and remember that extremes of temperature can damage most medications.
Holidays, travel, time off, going out
Think about how going away for a break or on holiday could impact on your adherence. This could include the influence of travel on the times you take your medication, particularly if you are travelling a long way involving a changed time zone. You should try and ensure that you take your medication at the same intervals. Make sure that you take enough medication with you, as securing more supplies might be impossible. You should also travel with your medication in your hand luggage as this is less likely to get lost and means that your medication is close at hand should you need to take any during your journey.
Breaking your routine may also have an impact on adherence as you may be away from prompts that helped you remember to take your medication. Think about what these might be and how to overcome them.
Taking your medication away from home may mean that there is an increased chance that you will have to take it with people who do not know about your health, or who you do not want to know about it. Plan in advance how you might manage this. Simple things such as having a bottle of water by your bed might give you the privacy you need to take your medication.
If you are going out clubbing and think that there is a chance that you may not go home before your next medication dose or doses, then take enough medication to last you. Be aware that door staff may not be able to recognise prescription medication and some people have been asked what their anti-HIV drugs are or have had them taken off them when trying to get into some clubs. Also if you are going out and are planning to drink alcohol or take drugs which might affect your memory, then try to plan in advance how you might overcome this. This might involve setting an alarm on your watch or telling a friend to remind you when it is time to take your medication. If you are concerned about possible interactions between HAART and recreational drugs then speak to your doctor or another member of your health care team. They should be able to offer advice on safely minimising interactions. Do not skip doses.
Treatment breaks
Taking a break from your treatments might seem attractive, particularly if you are having problems with keeping up with the high levels of adherence required, or if you are having severe side-effects. If you are having problems taking anti-HIV drugs, or with side-effects, discuss these with your doctor or another member of clinic staff rather than stopping treatment alone. They may be able to help solve these problems without needing to stop treatment. You should not take a complete break from your treatment without discussing this with your doctor first.
Sometimes, when people change treatment they are recommended to take a break before starting their new combination of drugs. They will be very closely monitored during this break. Also, if you have certain infections like hepatitis it might be necessary to stop your HIV treatment because of possible interactions and side-effects. Your doctor should tell you if this is the case.
Overcoming difficulties
For some people, taking the pills can be a problem depending on their size, shape and texture. Always mention problems to your HIV pharmacist. There may be another preparation of the medication available, e.g. a liquid or powder that you might find easier to take than a pill.
Taking an accurate amount of liquid formulations can be a bit tricky. An oral syringe from your pharmacist will help with this process, but you do need to wash and dry them thoroughly between uses. To take a single dose with you when leaving home, ask your pharmacist for an oral syringe cap. Though this will allow you to fill the syringe before you leave, you will need something suitable to protect the plunger. Some people inject liquid formulations into gelatin capsules, which can be bought from health food stores. This can be a very messy process and ensuring that you take an accurate dose may be difficult, so discuss this with your pharmacist first.
Using a pill crusher can make some pills easier to take. These are available from your HIV pharmacist who will advise you if it is suitable for the drugs you are taking. Pill crushers look like small jars - put the pills inside and then screw on the top. This crushes the pills inside the container.
If you are having ongoing difficulties taking your mediacation, or are worried, ask for help immidiately. Your treatment centre is there to help.