Maintaining antiretroviral adherence: An ongoing challenge for women with HIV

Maintaining antiretroviral adherence is an ongoing challenge and important aspect in achieving the World AIDS Day 2013 aim of 'Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths'

To mark World AIDS Day (December 1, 2013), Women for Positive Action - a global, multidisciplinary group of experts committed to addressing the specific concerns of women living with HIV - has released a commentary highlighting the challenges faced by women in maintaining adherence to their antiretroviral treatment. The commentary is available to read on the newly redesigned Women for Positive Action website (http://www.womenforpositiveaction.org) and highlights the importance of identifying, and overcoming, the barriers to adherence to slow the progression of HIV, and prevent onward transmission of the disease.

Adriana Ammassari, HIV Physician, Italy and faculty member of Women for Positive Action explains, 'Sub-optimal antiretroviral intake may lead to virological failure, drug resistance, increased morbidity and mortality, onward HIV transmission, and increased health care costs. Women living with HIV need to be supported by health care systems and are of utmost importance for achieving a change in public opinion regarding HIV, because of their key role in families and society.'

The commentary, developed by Fiona Mulcahy (St James's Hospital Dublin, Ireland), Adriana Ammassari (National Institute for Infectious Diseases, Italy), Annette Piecha (HIV Advocate, Germany), Mariana Mardarescu (Institutul Matei Balș, Romania) and Anne-Mette Lebech (Hvidovre University Hospital, Denmark) on behalf of Women for Positive Action, provides further expert opinion on the implications of poor adherence in women living with HIV.

Antiretrovirals have been shown to suppress HIV, contributing to substantial reductions in HIV-related morbidity and mortality among people receiving treatment. However, poor adherence detrimentally affects virological control and subsequently disease progression; as well as contributing to elevated rates of antiretroviral resistance. Women living with HIV face a number of challenges unique to their gender which may impact upon medication adherence, including: personal and mental health factors; social factors, such as communication; and resource factors, such as medication and transport costs. In addition, studies report a higher rate of discrimination among women living with HIV than in men and this too contributes to poorer antiretroviral adherence.