What if we could give PLHIV more autonomy to choose?
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
- PLHIV
- 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.
