Drug Regimens Causing "Battle Fatigue".

• Position: Brief Article

Twenty years after the start of the epidemic, "AIDS battle fatigue" is visible, with HIV-positive individuals finding it difficult to comply with their drug regimens and looking to take fewer and better drugs, according to data from a survey underwritten by GlaxoSmithKline, Research Triangle Park, N.C. While the data are not representative of all HIV-positive people and participants did not necessarily respond to each question, the survey offers insight into current perspectives on treatment.

Sixty-two percent of the respondents who are taking medication said it is somewhat or very difficult to adhere to their prescribed anti-HIV/AIDS drug plan. The major obstacle to complying with treatment every day is "too many pills," cited by 67%, followed by side effects (61%), food restrictions (55%), frequency of having to take the pills (49%), and the timetable for having to take them (48%). One percent noted cost as an obstacle. Many reported the drug regimen interferes with their daily life (43%), lifestyle (30%), or job (11%).

Difficulty in Adhering to Prescribed Plan Somewhat Difficult 57% Not Difficult 38% Very Difficult 5% Note: Table made from pie chart. "There are many challenges to being adherent to the drug regimens.... You just really get so tired of taking the drugs, taking them with or without food, watching what you eat, and knowing that you're going to be doing this the rest of your life," explains David Morris, who was diagnosed with HIV in 1983 and is the administrator of the wellness program at Beth Israel Deaconess Medical Center, Boston. Morris has taken anti-AIDS medications for 15 years and counsels HIV-positive and other individuals as part of his job. Morris takes 14 pills a day and has had multiple treatment failures and new regimens over the years.

According to Charles Farthing of the AIDS Healthcare Foundation in Los Angeles, the adherence problems for HIV-positive people are not wholly unlike those of people with other chronic illnesses, but the repercussions for those with AIDS can be deadly. "People with hypertension or high cholesterol can have a difficult time complying with their treatment plan on a daily basis, so we are certainly not surprised about adherence issues with HIV-positive people, who can have far-more complicated regimens. Adherence is of...