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October 15, 1997

Issues Regarding Antiretroviral Treatment for Patients With HIV-1 Infection

Author Affiliations

Yale University New Haven, Conn
University of California, San Francisco

JAMA. 1997;278(15):1233-1234. doi:10.1001/jama.1997.03550150037025

To the Editor.  —In their Consensus Statement, Dr Carpenter and colleagues1 stress that adherence to the drug regimen is critical for reducing plasma human immunodeficiency virus (HIV) RNA levels, protecting against drug resistance and cross-resistance, and enhancing patient health. Decisions to initiate combination therapy must take into account patients' willingness to adhere to complex and costly regimens that may include 20 or more pills per day. Even brief periods of nonadherence to treatment regimens can result in increased viral load and drug resistance.1,2Despite this, there is a dearth of information about adherence to therapy for HIV disease. Little is known about shortterm or long-term patterns of adherence to regimens like those recommended, how adherence behavior may change in response to disease progression, and factors that predict adherence and could be targeted for interventions.3 There is an immediate need to understand adherence behavior to realize the benefits