DON’T STOP! KEEP GOING.

There are many reasons why people living with HIV may interrupt or stop taking their ARVs. These could include lack of access to healthcare and medication, cost of treatment, stigma and discrimination, side effects of the medication, difficulty adhering to a strict regimen due to addiction, being homeless or financial challenges. Additionally, some people may not be aware of the importance of sticking to their treatment plan or may not fully understand the consequences of not taking their medication as prescribed.

South Africans are feeling the pressure as our economy takes a beating. The cost of living keeps going up, forcing us to re-evaluate what we spend our money on. We compromise on some things to suit our budgets whereas others we choose to live without.

This can put some people in very stressful situations where choices have to be made to survive. This is particularly tough for people who live with HIV and are forced to choose between food, electricity, or getting hold of their life-saving HIV medication which in turn can force a person to not be adherent on their ARVs.

It’s important to understand why adherence to your ARVs is very important and why it should be avoided at all costs.

Modern ARVs (HIV medication) are highly effective at controlling HIV. When taken as prescribed, ARVs can suppress the virus to undetectable levels, which means that the virus is present in the body but at such low levels that it cannot be detected by standard laboratory tests. This is known as viral suppression or undetectable.

When an individual’s HIV is suppressed, the risk of transmitting HIV to others is greatly reduced, and when a person reaches the undetectable level, the chances of passing HIV onto someone are 0%. Additionally, if an individual is virally suppressed, their CD4 count (a measure of the immune system’s health) will typically increase and the individual’s risk of developing serious health complications from HIV is also reduced.

It’s important to note that adherence to ARV treatment is crucial for it to be effective. Missing doses can lead to the development of drug-resistant strains of HIV in your body, which can make treatment more difficult and expensive in the long run.

Staying adherent to your ARV treatment can be challenging, especially when facing financial struggles. Here are a few strategies that may be helpful:

• ARVs are widely available in South Africa and one can get them for free from HIV-focused NGOs or government clinics.
• Look into assistance programs: Some organisations like EMH provide services on certain days that might be easier to access than going to a clinic. Some organisations also have drop-off services for meds. Speak to your HIV caregiver and ask if these types of services are available.
• Plan ahead: Try to plan to make sure you always have enough medication on hand. You can also ask if your HIV healthcare provider can supply more than just a month.
• If you are worried about taking ARVs on an empty stomach, remember that ARVs can be taken with or without food. The majority of ARVs work better taken on an empty stomach and this could help reduce side effects if you recently started ARV treatment for the first time.
• Use medication reminders: Set reminders on your phone or use pill boxes to help you remember to take your medication.
• Don’t skip doses to make the ARVs last for a longer period. You need to try to be at least 98% adherent every month for them to work This means you cannot skip more than two doses a month.
• Find a support system: Talk to friends and family or join a support group for people living with HIV like Positively Alive. This can help you feel less alone and provide an extra layer of support.