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If the patient's condition is such that exceptional adherence is required, such as approaching no missing dosages, intensive educational measures, and customization of the individual's regimen are required.
Lifelong antiretroviral therapy (ART) (Option B+) is recommended for all HIV-infected pregnant/postpartum women, but high adherence is required to maximize HIV prevention potential and maintain maternal health.
While high adherence is required to maximize the probability of durable viral suppression, the range of adherence capable of sustaining viral suppression is wider after prolonged periods of viral suppression.
Good adherence is required for a positive treatment effect.
Full adherence is required to avoid wet nights.
At least 90 95% of adherence is required to achieve optimal treatment [ 21].
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Finally, improved methods of measuring adherence are required for large-scale studies.
Therefore, adequate intensity, progression and adherence are required, or benefits will not accrue or persist.
Considerably high levels of adherence are required to suppress viral replication and boost CD4-positive-T-lymphocyte count [ 3– 6].
The World Health Organisation advocates an "adherence counseling toolkit" that can be used to systematically assess barriers and facilitators to adherence, and suggests that new interventions to enhance adherence are required [ 32].
High rates of health worker adherence are required if the benefits of the new protocol are to be realised and the consequences of poor adherence, such as misdiagnosis, over- or under-treatment and the accelerated development of drug resistance, averted.
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