'Take a well deserved festive season break but not an ARV holiday,' warns HIV advocate

The festive season is upon us and while it's the season to be jolly, HIV experts caution the festivities can derail routines for those on chronic treatment such as antiretrovirals (ARVs).

Many patients stop taking their medication, leaving them at risk of high viral load and ill health.

Sandile Prusente, programme director at TB HIV Care, said December is a particularly challenging time of year for treatment adherence. 

“At this time of year, people are out of their regular routine. They might be travelling over the school holidays, away from their local clinic or healthcare facility, and celebrating the festive season with family and friends or attending to traditional rituals.” 

Prusente said contributors to people not taking medication over the holidays include simply forgetting to collect them from clinics or to take their pills daily. Some avoid going to clinics and standing in queues, others fear stigma and discrimination by family members “especially if they haven’t disclosed their status”.

Daily adherence to HIV medication is important, both to prevent onward transmission of HIV and to protect a person’s health and wellbeing. “This is because even when one’s viral load is undetectable, HIV is still present in the body,” said Prusente.

“If a person living with HIV starts missing doses, either by taking a treatment holiday or stopping completely, their viral load rebounds and they run the risk of becoming ill, developing drug-resistance or passing HIV on to their sexual partner.” 

Stopping HIV medication is not recommended and research shows that people taking a treatment holiday are more likely to be ill. 

Prusente said taking a treatment holiday is a threat to progress made in HIV treatment including one of the biggest milestones to date — undetectable equals untransmittable (U=U), which is referred to as an undetectable viral load. Medically this means when one is virally suppressed at this stage, HIV cannot be passed on sexually. 

To counter poor treatment adherence, TB HIV Care in partnership with the health department’s Welcome Back campaign is raising awareness about U=U and encouraging people who have stopped taking their medication to visit their nearest clinic. 

The campaign seeks to support re-engagement and retention of people living with HIV who were diagnosed but never initiated treatment, including those who were initiated on treatment and interrupted or missed treatment appointments.   

For Prusente, the campaign is an important one. “People need to feel supported in their treatment, welcomed by the clinic staff, offered counselling and psychosocial support, and know that with today’s treatment they can live a full and productive life.” 

In the Eastern Cape, the organisation is also working with traditional leaders and community-based organisations to explore different solutions such as community pickup points for ARVs and medication for other non-communicable diseases. 

Tips to adhere to treatment:

• Take medication at the same time daily. 
• Link pill time to a daily activity, such as brushing teeth or bedtime. 
• Have a pill box to sort medication and keep track of it.
• Planning helps. Let the clinic or doctor know about travel plans to secure an extra supply of medication. 
• Set an alarm or have daily reminders to help stick to the treatment routine.

TimesLIVE