CPD articles

Adherence to antiretroviral therapy in HIV seropositive adults

Antiretroviral therapy (ART) non-adherence is one of the strongest predictors of the advancement of human immunodeficiency virus to AIDS, and a known causative effect of medication-resistant strains of the virus. With non-adherence between 57.2% and 10.1% in the UK, and with the advancing role of nurses at the forefront of HIV care, it is important nurses have the evidence-based knowledge to promote adherence effectively. The aim of this article is to review research identifying the barriers to and predictors of ART adherence, and the efficacy of interventions to overcome barriers and promote long-term successful therapy. Barriers identified included adverse-effects of treatment, complicated regimens, lack of social support and co-morbid mental health disorders. Numerous interventions to improve adherence are available to healthcare workers, including educational, technical and behavioural interventions. However, a combination of interventions tailored to the individual, seem to yield the greatest results. This article concludes that ensuring maximum contact between patient and a named nurse leads to improved continuity of care. This way, a trusting relationship can be developed, enabling effective monitoring of barriers to adherence and use of appropriate interventions.

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