Adherence to HAART: perspectives from clients in treatment support programs

The development of highly active antiretroviral therapy (HAART) has resulted in dramatic decreases in morbidity and mortality for HIV-infected individuals. Because the long-term efficacy of HAART is dependent on near perfect adherence, many providers offer services to support adherence, including education, regimen review, counseling, and reminder tools. Little is known regarding the utilization or efficacy of these services. In this paper, we report on data collected during 32 open-ended interviews conducted with individuals receiving services through the New York State Treatment Adherence Demonstration Project. Participants in the project reported deriving benefits from a broad range of project activities. Educational efforts helped clients to recognize HIV as a manageable, rather than terminal, illness. Information and tools focused on specific regimens provided clients with concrete knowledge and skills. Effective communication with medical providers and pharmacists was facilitated by adherence staff who proactively advocated for client needs. Program-based social support was particularly valuable for many participants, helping them to retain needed motivation and strength. Educational, practical, and supportive services were all considered valuable to clients participating in adherence support programs. A mix of services may best meet the range of needs found among persons taking HAART.