Treatment Literacy/Information needs/Adherence

=Adherence=

Why is adherence important?
Adherence to HAART (highly active antiretroviral therapy) is a major determinant of its biologic, clinical and public health outcomes:
 * Poor adherence is a major cause of ARV failure: Adherence affects how well anti-HIV medications decrease the viral load. When a medication dose is skipped, even just once, the virus has the opportunity to reproduce more rapidly. Keeping HIV replication at a minimum is essential for preventing AIDS-related conditions and death. Taking anti-HIV medications correctly (adherence) increases your odds of success.
 * Poor adherence is a major cause of ARV resistance and, with continuing risk behavior, transmission of resistant organisms. Skipping a dose may develop strains of HIV that are resistant to the medications taken and even to the medications not yet taken. This may leave fewer treatment options if the treatment regimens need to be changed in the future. Because drug-resistant strains can be transmitted to others, engaging in risky behavior can have especially serious consequences. Although there are many different anti-HIV medications and treatment regimens, studies show that the first regimen has the best chance for long-term success. Taking anti-HIV medications correctly (adherence) increases the odds of success.

Materials
Some techniques have been shown to improve adherence such as: Medication manager, Peer support, Electronic reminders, Home visiting, Modified DOT (directly observed therapy)… Such a combined approach to adherence works best.
 * [[Image:ARV dosing symbols card-p1.jpg|thumb|250px|left|Boehringer Ingelheim’s Antiretroviral Agents Adult Dosage Card with symbols for illiterate or low literate audience (2007 edition)- page 1]][[Image:ARV dosing symbols card-p2.jpg|thumb|250px|center|Boehringer Ingelheim’s Antiretroviral Agents Adult Dosage Card with symbols for illiterate or low literate audience (2007 edition)- page 2]]

Adherence improvement strategies
For more resources on adherence improvement strategies search "adherence" here (abstracts search) 1- Rabkin M, El-Sadr and W, Abrahams E (2005) MTCT-Plus Clinical Manual, p. 12, Mailman School of Public Health Columbia University, New York Also available at http://www.columbia-icap.org/resources/supporttools/index.html