Medication adherence among HIV-infected patients: Understanding the complex behavior of patients taking this complex therapy

Adherence to antiretroviral regimens by HIV-infected patients is necessary to prolong viral suppression and forestall viral resistance. This review covers the major advances made in research on adherence to HIV therapy in the past year. Currently, approximately 40% of patients receiving antiretroviral therapy have significant problems with adherence. Established predictors of poor adherence include depression, alcohol and illicit drug use, poor self-efficacy, and certain health beliefs. Medical providers are poor at predicting adherence. Interventions to improve adherence can have modest effects, and many types of interventions are effective. Multifaceted and repetitive interventions provide the most benefit. Medical providers, as part of the medical management of HIV-infected patients, should use interventions to achieve high levels of adherence to therapy.