Adherence to antiretroviral therapies in people with HIV infection: a qualitative approach from a narrative-based medicine study

Summary of results Twelve people with HIV were interviewed (four females).All interviewed people were taking HAART. Age range:38–65 years. Twenty-two hours of interviews wereobtained.Adherence to drugs was often reported as the crucial prob-lem in the daily management of the HIV infection. Amongreasons for suboptimal adherence several concepts wereelucidated through the interviews: 1) adverse eventsrelated to therapy are the main cause of suboptimal adher-ence; 2) particularly, alterations of body aspect due toabnormal adipose tissue redistribution (so-called lipodys-trophy) were identified as a strong factor leading to sub-optimal adherence; 3) reduction or modification of dailydosage of antiretroviral drugs were reported very fre-quently (11/12 interviewed people, 91.6%). They wereoften done without informing the physician. The mainreason for doing a reduction or modification of daily dos-age was an adverse event. People often believe that physi-cians could not be aware of these modifications since noimmediate change in viral load is detectable; 4) subopti-mal adherence to drugs was correlated to a poor belief indrug efficacy; 5) the social representation of the drug ofteninfluences adherence; and 6) the drug experience often isa reminder of the psychological experience of the illness.