HIV drug regimens are hard to maintain

HIV-positive individuals find it difficult to comply with their drug regimens, according to data from "The Survey on Treatment Adherence by HIV-positive People," a confidential survey conducted by Chicago-based Savitz Research and underwritten by GlaxoSmithKline, Research Triangle Park, NC.

A total of 371 HIV-positive individuals responded to surveys distributed by questionnaire to 2,500 households that had reported having an HIV-positive member, and via the Internet to another 2,602 individuals. The data are not representative of all HIV-positive individuals, and participants did not necessarily respond to each question, but the survey offers insights into current perspectives on HIV treatment.

A total of 62% of the 292 HIV-positive respondents who are taking medication said it is somewhat or very difficult to adhere to their prescribed anti-HIV/AIDS drug plan. The major obstacle is "too many pills," cited by 67% of respondents, followed by side effects (61%), food restrictions (55%), frequency of pill-taking (49%) and timetable for pill-taking (48%). Many reported that the drug regimen interferes with their daily life (43%) or lifestyle (30%), as well as their job (11%).

Treatment changes

The survey asked the 292 respondents currently taking HIV drugs to identify the three most important changes that would make anti-HIV drugs easier to take. Administration issues (how drugs must be taken) were indicated at least once among the three responses by 93% of the 266 people responding, including "reducing the number of times you need to take pills" (45%), "having fewer pills to take" (41%), and "having a single pill rather than multiple pills" (18%). Respondents were able to choose multiple answers.

Similarly, when asked to name what the most important characteristic of a "better" HIV drug would be, 67% of the 259 HIV-positive respondents wanted to improve administration aspects, which included a reduction in the number of times to take the pills (25%), fewer pills (25%), a single pill rather than multiple pills (19%), and "making the drugs easier to take" (15%). Also, 58% wanted to "lower the amount of side effects." Another 28% wished for improved efficacy, and 8% wanted to lower cost.

Physician preparation

A series of questions assessed how HIV-positive respondents' physicians or healthcare providers prepared them for taking anti-HIV/AIDS drugs. One out of every four of the 278 respondents said his or her physician gave no preparation prior to starting the drug regimen. A total of 36% of 291 respondents said they were not mentally prepared to start their drug plan.

Respondents seemed to understand the importance of strict compliance. When asked, "How important is it for an individual to stay with the prescribed anti-HIV/AIDS drug plan," 85% of 370 responding rated it from 8 to 10, 10 being "very important." Only 3% rated it 0 to 2.

"It may be difficult for people without HIV infection to understand why someone wouldn't be absolutely perfect about taking drugs that can prevent the development of AIDS or slow its progression. But we must realize that taking drugs is a reminder that people are 'sick' and the drugs often come with annoying or sometimes debilitating side effects," said Charles Farthing of the AIDS Healthcare Foundation in Los Angeles. "Many people have trouble finishing a simple antibiotic regimen that requires a person to take two or three pills a day for only 10 days. Some HIV/AIDS patients might begin taking their pills at 6 a.m. and take up to 20 or 30 pills in the course of the day." PR