Ellen Campbell-Grizzle - PHARMACY TODAYTHERE IS current concern about how persons living with HIV/AIDS (PLWHAs) can get the best from their medication. These medicines can work for a long time if taken correctly. They do not cure HIV or reduce the risk of passing HIV to others. A combination of drugs can lower the amount of HIV in the body by stopping HIV from making copies of itself. In this way, medication preserve 'CD4' or 'T' cells that the immune system needs.
There are three basic types of HIV medication used in Jamaica. Nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) help stop the copying process in the early stages. Protease inhibitors (PIs) work later in the process by stopping the HIV copies from infecting healthy CD4 cells.
PLWHAs must be 95 per cent adherent to their medication regimen. If they do not follow all the directions for taking their treatment, resistance will develop. This means that new copies or 'mutations' of the virus become ' invisible' to the medication and the virus is no longer under control. A change of medication will have to be made. Since there is a limited number of medication for HIV, it is possible to exhaust treatment options.
Adherence is a crucial factor in making HIV medication last. At the recent meeting of the Caribbean HIV/AIDS Regional Training Network (CHART), held in Montego Bay, many related issues were shared between health care providers and PLWHAs. A great deal of time was spent in discussing the role of the multidisciplinary team, including the patient, in achieving adherence.
How can a PLWHA preserve the ability of their medication to work? Firstly, you need to take all of them as prescribed. No matter how strong they are, they will not work if they are not taken the right way. There must be enough drug in your blood at all times to prevent HIV from making copies of itself. It is not easy to take the medication at the right time and in the right way but you can do it. Here are seven tips that have helped others and should help you:
Plan to succeed educate yourself about HIV and its treatment. Stay healthy and avoid risky behaviours.
Build and use your support team your doctor, pharmacist, nurse, family and friends are key members of your network. Select people who you believe are competent and care about you. People cannot read your mind and can only help if you explain things, even if they are difficult to talk about.
Talk to your doctor and pharmacist about medication side effects.
Use reminders many people simply forget to take their medication when they should. Different things work for different people.
Think ahead work can be a difficult place to take your medication. Identify the best times to take your medication and request the most appropriate break time from your supervisor.
Develop a positive attitude think of HIV as a chronic long-term condition like diabetes. Everyone gets depressed but it is important how you deal with it.
Reduce stress job demands, busy schedules, living expenses, cost of medication and family demands can add to stress. No matter what, never skip your medication.
Visit your doctor regularly so that he can assess your success and keep track of how your immune system is progressing. The higher your CD4 count, the healthier your immune system. Also, listen to your body, get plenty of rest and be positive. If you want to know how to best manage the side effects of your HIV medication, ask your pharmacist, you have the right to know!
Ellen Campbell-Grizzle, President, Caribbean Association of Pharmacists (CAP); Director, Information & Research. National Council on Drug Abuse; email: yourhealth@gleanerjm.com.
