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Importance of adhering to HIV treatment

Strict adherence is key to reducing the risk of drug resistance1

Ongoing adherence to a prescribed regimen is essential for maintaining viral suppression.
Maintaining viral suppression can help decrease HIV-associated complications; viral suppression is second only to CD4 cell count as a predictor of disease progression. Additionally, according to the DHHS guidelines, as long as a patient achieves and maintains an undetectable viral load for at least 6 months, sexual transmission of HIV to the patient’s partner can be prevented.1

Patients with problems adhering to ART should be prescribed regimens with high genetic barriers to resistance.1 Resistance to a drug not only makes it ineffective in treating their HIV, but it can lead to cross-resistance to the entire class of HIV medication.2

Many patients living with HIV are not retained in care; therefore, they are not maintaining virologic suppression. HIV testing, linkage to care, initiation of effective antiretroviral therapy, adherence to treatment, and retention in care is often referred to as the HIV treatment continuum.1

WHAT DOES OPTIMAL ADHERENCE ACHIEVE?

Barrier to resistance icon. Lower rates of resistance
Medical icon. Better health
Arrow pointing downwards. Maintains suppression
X icon. Helps prevent transmission

The importance of the HIV treatment continuum3,4

Percentage of people living with HIV among 1.2 million people aged 13 years and older
Prevalence-based HIV Care Continuum, US and 6 Dependent Areas, 2019

Person representing 87%.

87%

Diagnosed

Person representing 66%.

66%

Receiving Care

Person representing 50%.

50%

Retained In Care

Person representing 57%.

57%

Virally Suppressed

As of 2019, ~66% of all PLWH were receiving care, yet only 57% were virally suppressed3

HIV care retention

Retention in care is defined as regularly attending medical appointments and remaining in medical care. Retention in care is a vital aspect of treatment adherence, and may lead to better outcomes for patients.1

Successful adherence to HIV medication can benefit patients and help them reduce the risk of drug resistance, avoid HIV transmission, achieve and maintain viral suppression, and remain in care.1

ART, antiretroviral therapy; CD4, cluster of differentiation 4; DHHS, US Department of Health and Human Services; PLWH, people living with HIV.

References:

  1. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. Department of Health and Human Services. Updated May 26, 2023. Accessed July 24, 2023. https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/guidelines-adult-adolescent-arv.pdf
  2. HIVinfo.NIH.gov. Glossary of HIV/AIDS-related terms. Updated 2021. Accessed January 17, 2022. https://clinicalinfo.hiv.gov/sites/default/files/glossary/Glossary-English_HIVinfo.pdf
  3. HIV.gov. HIV care continuum. Published June 21, 2021. Accessed November 15, 2021. https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum.
  4. Centers for Disease Control and Prevention. HIV surveillance. Published August 5, 2021. Accessed November 15, 2021. https://www.cdc.gov/hiv/library/reports/hiv-surveillance.html