JCRC Radio Talk Show Outline

Adherence

Objectives of the radio programme:

1. What does adherence mean?

Adherence means taking doses of drugs and sticking to the treatment plan – or ‘treatment regimen’ - exactly as prescribed.
Adherence also means taking the correct dose of drugs, at the correct time and in the correct way (for example, with the right type of food or fluid, and before or after a meal).
Adherence also involves looking after drugs to make sure that they are effective and safe to use.

ART drugs must be taken everyday at certain times each day. This is because the amount of drug in the body must remain at the same level all the time.
Some ART drugs must be taken when the stomach is empty, but others only after eating some food.
For the drugs to work, it is very important that you take them at the same times, in the right amounts, every day for the rest of your life – even if you stat feeling strong and healthy.

Why it is so important for children on ART not to miss taking their medicine

Missing doses can lead to drug resistance. This means that the drug you were taking doesn’t work anymore for you. Your health care provider will then have to find a new one and often that is difficult and expensive.
Drug resistance also means that over time some of the drugs used to treat AIDS will no longer work for anyone. When this happens, there will no longer be any form of treatment for AIDS.
Just as in adults, children need to take their medicine as directed in order to stay healthy.

Ways of helping a childto adhere

Involving the child
Having a good relationship between the caregiver, child and their treatment provider.
Finding out what beliefs a child has about HIV and ARV treatment, discussing them and correcting any false information. This might involve addressing specific issues, such as someone’s lack of trust in medication or beliefs that ARVs are poisonous.
Providing clear and accurate information about HIV and ARVs that is appropriate for a child’s specific needs. This includes: what treatment can and cannot do; what to do about side effects; what to do to ensure adherence and prevent drug resistance; and what happens if treatment has to be changed.
Providing a child with access to counselling and support from health workers and other treatment supporters.
Regularly monitoring the progress of the treatment - through clinical check-ups and asking specific questions about adherence.
Assessing and doing something about the child’s psychosocial concerns. These might include: stress; depression; stigma and discrimination.
Having a personal treatment supporter
Involving a wide range of people – such as family, friends
Providing opportunities for the child to share their experiences with fellow children who are taking ARVs successfully.
Providing methods to help a child remember especially those in boarding schools

Having a non-judgemental approach and accepting that almost everyone misses doses of drugs sometimes.
Assessing and building a child’s overall motivation for treatment.
Checking a child’s adherence by asking specific but open questions such as: “In the last month, how many doses do you think you missed?”
Clarifying and checking a child’s understanding of their drug regimen.
Addressing a child’s patterns of non-adherence. For example, looking at whether non-adherence is associated with particular social situations, behaviours or thoughts.
Providing a child with additional support when needed – to help them remember their doses, talk about their experiences and encourage them to continue their treatment.
Use models of other children who are healthy as a result of taking their medication well.