Barriers to adherence to highly active antiretroviral therapy as expressedby people living with HIV/AIDS

The primary objective of this study was to gain a clearer understanding of the barriers to adherence to highly active antiretroviral therapy (HAART) f aced by people living with HIV/AIDS (PLWHIV/AIDS) on Long Island, New York. Focus group, a qualitative research method, was used to study these barrie rs. The study was conducted in 1998 on Long Island, NY, at five institution s that provide services to 1700 PLWHIV/AIDS. Five focus groups were conduct ed with 6 to 13 PLWHIV/AIDS in each group, a total of 39 subjects. PLWHIV/A IDS identified eight common barriers to adherence to HAART. In descending o rder, the barriers include: (1) frequency and severity of side effects, (2) conflicts with daily routines, (3) dietary requirements, (4) frequency of taking medications, (5) number and dosage of medications, (6) psychosocial factors (i.e., stress, feeling good, and bad news), (7) pharmacy refills, a nd (8) physiological, needs (i.e., sleep, hunger, or thirst). Many factors play a role in the success or failure of HAART, including preexisting drug resistance, drug-drug interactions, and the ability of PLWHIV/AIDS to adher e to a rigid and frequently changing medication regimen. The information gl eaned from focus groups is limited in that it may not be generalized to a l arger population with any known reliability. However, clinicians sensitive to barriers to adherence to HAART, including those identified by PLWHIV/AID S in this study, may play a more proactive role in supporting adherence to the medication regimen, increasing the durability of effective viral suppre ssion, decreasing morbidity and mortality, and decreasing the selection and transmission of resistant strains of HIV.