Final Facilitator Guide - EngenderHealth

Section 54. Adherence to treatment is profoundly affected by systems of care; ifthe system meets the needs of the socially marginalized, there is avast improvement in adherence to treatment.5. The key to effective treatment is careful assessment and educationof the person, leading to development of an individualized treatmentplan to maximize adherence6. Special considerations for this population includea. Dealing with instability in lifestyle, which challenges drug adherence.Facilitator’s Guide4Adherence to Treatment for HIVb. Accounting for the potential drug interactions of ARV with agentssuch as methadone, which decreases the level of Efavirenz in thebody.c. Dealing with arrest and detention can affect adherence for drugusers in prison.d. ART medications can cause liver side effects, and for people usingdrugs there is a higher risk of having liver complications becausepeople using IV drugs are likely to have Hepatitis ‘B’ and ‘C’, whichdamage the liver.7. To help people adhere to ART in such settings, peer educators canrecommend the following :a. Directly observed therapy can be implemented.b. Dispensing of medications in pre-filled pillboxes, initially on a weeklybasis, then every two or four weeks.c. Dispensing on a weekly or more frequent basis at needle exchangeor other harm reduction sites.102