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HIV THERAPIES
Drug adherence counselling is a four-stage approach that incorporates principles of learning theory, the
daily living challenges of the patient and the complexity of medical and psychosocial factors specific to HIV
practice.1 The four-stage approach, which is now a standard at the Integrated Treatment Centre, consists
of (a) General preparation, (b) Treatment initiation, (c) Consolidation; and (d) Maintenance. Drug
adherence interventions integrate affective, behavioural, and cognitive strategies. Affective strategies are
designed to optimise social and emotional support. Behavioural strategies are designed to shape, reinforce
or influence behaviour. Cognitive interventions are designed to teach, clarify and provide treatment
information.3
Review the regimen and the medication schedule and simplify the regimen to facilitate a better
match of schedule to life pattern.
References
1.
American Public Health Association. Adherence to HIV Treatment Regimens: Recommendations for
Best Practices. Wahington DC: APHA, 2004. Available from www.apha.org/ppp/hiv (accessed 25
April 2006).
2.
World Health Organisation. Chronic HIV Care with ARV Therapy. Interim Guidelines for First-Level
Facility Health Workers. Integrated Management of Adolescent and Adult Illness(IMAI).
Geneva:WHO, 2003. Available from www.who.int//htm/IMAI/Modules?IMAI_chronic.pdf (accessed
25 April 2006).
3.
4.
Fong OW, Ho CF, Fung LY, et al. Determinants of adherence to highly active antiretroviral therapy
(HAART) in Chinese HIV/AIDS patients. HIV Med 2003;4:133-8.