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Respecting patient choice can lead to greater patient satisfaction[1] - and in turn can lead to better clinical outcomes and QoL[2][3]

They’re kind of directing where it’s going, but at the same time I have control over it. So if they tell me something and it doesn’t seem like something I want to do, I’ll go read about it, and then I’m like, okay, yes or no.[4] -PLHIV

Now I’m at a point where perhaps people should be all the time. I disagree with what my doctor is saying and I’m like, ‘‘No, I asked you for this information and you’re telling me this and I really want this information.’’ That’s the way I am now, but in the beginning I just sort of handed myself over, ‘‘You people know what’s going on, I don’t’’.[4] -PLHIV

There is a need for treatments that can exist in parallel to the individual lifestyles of PLHIV. Even the simplest of ART regimes can get in the way of everyday life.

A treatment provides an individual approach to a diversifying HIV population

Diversity is increasing in the HIV patient population in terms of age, race, ethnicity and gender.[5][6] Moreover, PLHIV can be prevented from adhering to treatment due to changes in routine, a hectic schedule or sleeping away from home[7] :

A more individualised treatment approach with collaboration, mutual responsibility and shared HCP patient goals is required[5]

A treatment that puts disclosure in the hands of the patient

Concerns of inadvertent disclosure can inhibit PLHIV from taking their medication in the company of others[8]

In some cases, its not because PLHIV forget to take their medication, but because they cannot afford the consequences of revealing their status[8]

A treatment that engages PLHIV in their own care

Many PLHIV are experts of their own condition and hold valuable knowledge. They want to be involved in their own care:[5]

  • Patient engagement can improve treatment adherence, and in turn, clinical outcomes
  • Use of the valuable knowledge of PLHIV helps to strengthen the relationship between doctor and patient
  • Healthcare systems are becoming increasingly financially and time restricted – patients should be encouraged to engage in their treatment plans

Similarly to switching treatment because of physical events,[9] switching treatment due to mental, emotional and social needs can save lives, enhance outcomes[10][11] and ensure PLHIV have a life worth living

They’re kind of directing where it’s going, but at the same time I have control over it. So if they tell me something and it doesn’t seem like something I want to do, I’ll go read about it, and then I’m like, okay, yes or no.[12]

- PLHIV

Now I’m at a point where perhaps people should be all the time. I disagree with what my doctor is saying and I’m like, ‘‘No, I asked you for this information and you’re telling me this and I really want this information.’’ That’s the way I am now, but in the beginning I just sort of handed myself over, ‘‘You people know what’s going on, I don’t’’.[12]

- PLHIV

It may be time to look at the non-clinical adverse events of ART and consider the new possibilities of switching to a treatment that can change the way patients live with HIV

All images are for illustrative purposes only. Any person depicted is a model.

ABBREVIATIONS
ART: antiretroviral therapy; PLHIV: people living with HIV; QoL: quality of life.

References

Ahmed SI, et al. Eur J Pers Cent Healthc. 2017; 5(1): 138–144.
Casado JL, et al. HIV Med. 2016; 17(1): 46–55.
de Oliveira e Silva AC, et al. Rev Lat Am Enfermagem. 2014; 22(6): 994–1000.
Christopoulos KA, et al. AIDS Patient Care STDs. 2013; 27(4): 223–230.
Guaraldi G, et al. AIDS Rev. 2019;21:135–142.
Gilmore HJ, et al. AIDS Patient Care STDs. 2013;27(10): 560–566.
Chen Y, et al. Ann Behav Med. 2017; 51(1): 67–78.
Maiese EM, et al. Curr Med Res Opin. 2016; 32(12): 2039–2046.
Martikainen P, et al. Int J Epidemiol. 2002; 31: 1091–1093.
Harding R, et al. J Acquir Immune Defic Syndr. 2015; 70(5): e176–177.
Christopoulos KA, et al. AIDS Patient Care STDs. 2013; 27(4): 223–230.