Pharmacotherapeutics for advanced practice: A practical approach (4 th ed.). Philadelphia, PA: Wolters Kluwer. Camacho-Gonzalez, A. F., Wallins, A., Toledo, L., Murray, A., Gaul, Z., Sutton, M. Y., . . . Chakraborty, R. (2016). Risk factors for HIV transmission and barriers to HIV disclosure: metropolitan Atlanta youth perspectives. AIDS Patient Care and STDs, 30 (1),
18-24. doi:10.1089/apc.2015.0163 Krummenacher, I., Cavassini, M., Bugnon, O., & Schneider, M. (2011). An interdisciplinary HIV-adherence program combining motivational interviewing and electronic antiretroviral drug monitoring. AIDS Care, 23 (5), 550-561. doi:10.1080/09540121.2010.525613 Montaner, J. S., Lima, V. D., Harrigan, P. R., Lourenço, L., Yip, B., Nosyk, B., . . . Kendall, P. (2014). Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: The “HIV Treatment as Prevention” experience in a Canadian setting. PLoS ONE,9 (2), e87872. doi:10.1371/journal.pone.0087872 Sax, P. E., Hirsch, M. S., & Bloom, A. (2018). The natural history and clinical features of HIV infection in adults and adolescents . Retrieved from .uptodate.com/contents/ the-natural-history-and-clinical-features-of-hiv-infection-in-adults-and- adolescents? search=hiv&source=search_result&selectedTitle=2~150&usage_type=default& display_rank=2 Response #1 Charlott, I enjoyed reading your post and agree that establishing a trusting relationship ship between provider and patient for HIV treatment is essential for medication adherence. Medical providers need specific interventions and goals to keep their patients wanting to continue their medications. Peer counselling, text reminders, cognitive-behavioral therapy, behavioral skills and medication adherence training, and fix-dose combinations and once-daily medication regimens are recommendation from the World Health Organization (WHO, 2013) to encourage
patients to continue taking their medications. For this to be successful; however, patients need to trust their providers. Individualized patient care plans need to be formulated to support chronic disease patients and involve not only the patient, but their family and friends as well (Krummenacher, Cavassini, Bugnon, & Schneider, 2011). Reasons nonadherence occurs is due to forgetting doses, being away from home, changes in daily routines, depression or other mental illnesses, and substance or alcohol abuse (WHO, 2013). Many individuals fear the stigma and discrimination that can occur with HIV and others find dosing regimens complicated (WHO, 2013). Special populations that have higher nonadherence rates are pregnant and nursing women, adolescents, infants and young children, patients with mental health disorders or substance use (WHO, 201). Establishing a deep and trustful provider-patient relationship with these groups and implementing adherence strategies can increase the knowledge and understanding of HIV and the treatment regimens and prevent drug-resistant strains and treatment failures (Krummenacher et al., 2011).
- Summer '15