A Qualitative Investigation of Adherence Issues for Men Who are HIV Positive‪.‬

Antiretroviral medications have given new hope to individuals with HIV fortunate enough to have access to them. In the United States, deaths as a result of AIDS declined in 1996 for the first time by 25 percent, and age-adjusted death rates from HIV infection declined by 47 percent from 1996 to 1997, reaching the lowest rate since 1987 (Centers for Disease Control and Prevention [CDC], 2001; National Center for Health Statistics, 1998). Those declines, in large part, have been a result of advances in combination antiretroviral drug therapy. However, these drugs require strict adherence to complicated dosing schedules and dietary conditions in addition to management of distressing side effects. Social workers who provide services to HIV-positive individuals have a responsibility not only to understand and communicate how antiretroviral medications work and why adherence is so crucial, but also to be prepared to help individuals improve their levels of adherence. Because nonadherence can lead to drug resistance, the benefits of adherence extend beyond the individual to the public health. Even partial adherence creates the potential for development of mutant strains of the virus (Bangsberg et al., 2000; Roberts, 1995).