Adherence to antiretroviral therapy (ART) is critical to achieving viral suppression and preventing disease progression and transmission in patients with HIV. However, for individuals in low-resource settings, barriers such as poverty, limited healthcare access, and competing life priorities often impede adherence.1 Medical providers must employ targeted strategies to address these challenges, leveraging simplified regimens like once-daily combination pills to optimize outcomes.1,2
The advent of fixed-dose combination (FDC) pills has significantly transformed ART adherence. Medications like emtricitabine/tenofovir alafenamide combined with integrase inhibitors (e.g., bictegravir) offer potent, well-tolerated, once-daily options that simplify complex regimens.3 According to the Centers for Disease Control and Prevention (CDC), these combinations improve adherence and viral suppression rates, particularly in resource-limited populations, by reducing pill burden and minimizing dosing errors.1
To further enhance adherence, integrating comprehensive patient support systems is essential. Clinicians should advocate for multidisciplinary care models that include social workers, case managers, and peer navigators to address social determinants of health and provide culturally competent care.4 These teams can connect patients to essential resources such as transportation assistance, housing support, and nutrition programs, which directly impact adherence. 4
Innovative technology also plays a role in promoting adherence. Mobile health interventions, including SMS reminders and app-based tools, have shown promise in improving medication-taking behaviors.5,6 These low-cost interventions have been shown to be successful in patients with HIV and are particularly effective in underserved populations, offering scalable solutions to bridge gaps in care.6
Fostering strong patient-provider relationships remains a cornerstone of adherence. Providers should engage in open, nonjudgmental communication to address stigma, discuss potential side effects, and empower patients to take an active role in their care. Offering flexible clinic hours and community-based ART delivery models can also reduce barriers for low-resource patients.
By prioritizing simplified regimens like once-daily FDCs and implementing patient-centered support systems, medical providers can improve adherence in low-resource populations, advancing the goals of viral suppression and health equity.
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