Promoting long term adherence to antiretroviral treatment

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e4173 (Published 28 June 2012) Cite this as: BMJ 2012;344:e4173
  1. Edward J Mills, Canada research chair, global health1,
  2. Richard Lester, assistant professor, infectious diseases2,
  3. Nathan Ford, medical coordinator3
  1. 1Faculty of Health Sciences, University of Ottawa, ON, Ottawa, Canada, K1N 6N5
  2. 2Department of Medicine, Division of Infectious Diseases, University of British Columbia, Vancouver, Canada
  3. 3Médecins Sans Frontières, Geneva, Switzerland
  1. edward.mills{at}uottawa.ca

Patient support and community interventions are probably the best interventions

While funders start to backtrack on financial commitments to tackling the AIDS epidemic,1 the HIV research community is rallying because important steps are currently being taken in treatment, prevention, and the combination of the two.2 Not since antiretroviral treatment first became available have expectations been so high that its widespread use can break the back of the global AIDS pandemic. Research into an HIV vaccination has been funded for more than a decade, but long term antiretroviral treatment is still the most effective biomedical prevention tool available.2

For antiretroviral treatment to work as a preventive measure, however, patients must consistently adhere to treatment, yet our understanding of how to achieve widespread optimal adherence is still limited. Most people who take antiretroviral drugs reside in Africa—currently, more people in the small country of Zambia (283<thin>000) are taking these drugs than in the whole of the United States (268<thin>000).3 Although most patients in Africa adhere extremely well to treatment,4 a proportion of patients do not. It is important that …

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