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If you are a long-time reader of HIV Positive! magazine, you know that we run articles on adherence – which means taking all your medicines when you’re supposed to – more than any other subject. Why? Two reasons.

One reason is that adherence is vitally important. Multiple studies show that to make your HIV meds work and avoid drug resistance, you have to take 95% or more of your doses right on time. When someone on medications fails to get their viral load down to the “undetectable” level, it is almost always because they have not taken their meds as prescribed. Make no mistake: the drugs work. But they only work if you take them almost perfectly.

The other reason we write about this so often is that achieving 95% or better adherence, for many people, is difficult. People have lives to lead. They forget, they oversleep, they get distracted. A thousand different things can make you miss a dose.

But every time you miss a dose, you’re putting your life in jeopardy. Our goal is to help you live a happy, wonderful long life! So here are some ideas on how to stick to your regimen. We hope they help!

Your first regimen is your best shot at controlling your HIV. If you don’t stick to it precisely, the virus can mutate and develop resistance to your medicines.

This is not something you want to play around with. You don’t try out a regimen to see if you like it. If you try a regimen and fail, you’ve wasted at least one set of potentially life-saving drugs. So don’t blow this. Think it through before you start, and don’t start until you’re totally committed to success.

Before you begin an HIV regimen, ask your doctor for a written treatment plan. Find out exactly how many pills you’re going to have to take. Find out if you will be taking pills once-a-day, twice-a-day or more often. Ask if you can take your pills without regard to food, or if they should be taken with food or on an empty stomach.

And then – give it a test run. Buy a package of M&Ms or jelly beans, and take them on exactly the regimen your doctor prescribes for your HIV drugs. It’s a surprisingly realistic test – if you can’t take your jelly beans or M&Ms on time you’re not likely to do any better with the actual drugs.

If the regimen your doctor recommends turns out to be just too much for you, say so! Ask if you can take something simpler. All HIV regimens include a “cocktail” of at least three different medications. But today there are combination drugs – including Truvada, Combivir, Epzicom and Trizivir - that combine two or more of those medications into one pill, greatly reducing the total number of pills you have to take. Within a year, approval is expected on a new drug that will combine Sustiva and the ingredients of Truvada into one drug that only has to be taken once a day – the ultimate in dosing convenience. So if your doctor prescribes more drugs than you feel you can take, speak up.

It’s an unfortunate fact that some HIV medications have side effects – anything from diarrhea to crazy dreams – that can throw you off track if you don’t expect them. Before you start your regimen, ask your doctor what side effects you can expect, how long they’re likely to last, and what you can do to relieve them.

If you’re experiencing side effects you just can’t live with, don’t give up! Go back to your doctor and ask for help. You may have to go on another “cocktail” of drugs if the side effects persist.

A basic seven-day pill box – available at almost any drugstore – is one of the most useful tools you can use to help you stick to your program. Pick a day to stock it with your meds for the coming week. Do it in a well-lighted place with no distractions, and get it right. Then take your meds every day out of the correct day and time slot. This simple tool lets you see at a glance when you’ve taken your dose. And it shows you right away when you’ve missed one.

As with any other challenge, there’s nothing like a little support. Show your family and friends this article so they’ll understand how important adherence is. Let them know exactly what you’re supposed to take, and when. And ask them to help you remember.

As hard as adherence to your HIV meds may seem to you, millions of people around the world have it worse. People with type 1 diabetes prick their finger to check their blood sugar four or more times a day. They give themselves a shot of insulin with a needle and syringe four times a day as well. If they had the option of controlling their condition with a few pills a day instead, they’d jump for joy!

So don’t give yourself any excuses. Yes, this is hard – but it could be harder. (It was harder – a lot harder - for people with HIV just a few years ago!)

You can do this. And you must do it. This is not a game.

So take your meds. Right on time. Every time. Without fail.

Your life depends on it!

Copyright 2010, Positive Health Publications, Inc.

This magazine is intended to enhance your relationship with your doctor - not replace it! Medical treatments and products should always be discussed with a licensed physician who has experience treating HIV and AIDS!