When And How Should We Be Measuring Adherence To Antiretroviral Therapy In Resource-Limited Settings?

The primary goal of treatment with antiretroviral therapy (ART) is to prevent HIV-related morbidity and mortality. The effectiveness of ART has been clearly demonstrated, as have the positive relationships between adherence to ART and viral suppression, increased CD4 cell count, positive clinical outcomes,1,2 and reduced mortality.3 More recently it has been shown to associated with reduced risk of transmission to uninfected partners4 . High levels of adherence are critical for successful treatment. Accordingly, for ART programs to achieve their population level goals, individual adherence must be monitored accurately and frequently and prompt action must be taken when poor adherence is identified