Adherence Flashcards
What are 3 main benefits to suppressive ART treatment
- For the individual the HIV becomes a manageable chronic illness
- For the sexual partners the risk of transmission is removed
- For the country, the population become healthy and there is a decrease in the reliance on public health
What is the U=U theory
This is the fact that people who take their ART daily develop undetectable viral loads and this means that they have effectively no risk of sexually transmitting the virus
What are the 3 main difficulties related to ART adherance
- Choice to start ART [Initiation]
- Taking the daily dose of the medication [Implementation]
- The need for a long term relationship with the health system [persistance]
What is the 90 90 90 strategy in antiretroviral therapy
It aims to achieve three primary goals:
90% of all people living with HIV should know their HIV status – Ensuring widespread testing and awareness of HIV status.
90% of those diagnosed with HIV should receive sustained antiretroviral therapy – Ensuring that those who know they are HIV-positive have access to continuous and effective ART.
90% of those on ART should achieve viral suppression – Ensuring that ART is effective, with patients reaching an undetectable viral load to reduce transmission and improve individual health.
What are the 4 main steps in achieving viral suppression
- Diagnose
- Start ART
- Keep people in care
- Keep people virally suppressed
What are 4 methods for monitoring adherence
- Subjective adherence: This is where the patient is asked about their adherance and self reports
- Pill counts: This is where a patients remaining pills are counted at the next visit
- Electronic metods; Smart bottles are used that record when they are oppened
- Drug concentrations: This is when biological markers are tested in the blood or urine
What are 4 strategies that have been shown to improve adherence
- Education and counselling methods
- Electrical interventions
- Health system restructuring
- Economic based interventions
What are some of the electrical tools that aid in improving adherence
- Mobile phone interventions: The are weekly or daily calls or SMS to improve adherence
- Electronic monitoring devices: Smart Pill Bottles
What are some of the barrier that are related to health system that influence adherence
- Long travels to clinics
- Long wait times at the clinics
- Clinics being out of stock
- Negative interactions with staff