Download JCRC Radio Talk Show Outline

Adherence
Objectives of the radio programme:
1. To inform the audience about the importance of adherence
2. To discuss the key issues in adherence
3. To help identify ways of enhancing adherence among children on ART
1. What does adherence mean?

Adherence means taking doses of drugs and sticking to the treatment plan – or
‘treatment regimen’ - exactly as prescribed.

Adherence also means taking the correct dose of drugs, at the correct time and
in the correct way (for example, with the right type of food or fluid, and before
or after a meal).

Adherence also involves looking after drugs to make sure that they are
effective and safe to use.
How to take ART drugs

ART drugs must be taken everyday at certain times each day. This is because
the amount of drug in the body must remain at the same level all the time.

Some ART drugs must be taken when the stomach is empty, but others only
after eating some food.

For the drugs to work, it is very important that you take them at the same
times, in the right amounts, every day for the rest of your life – even if you stat
feeling strong and healthy.
Why it is so important for children on ART not to miss taking their medicine

Missing doses can lead to drug resistance. This means that the drug you were
taking doesn’t work anymore for you. Your health care provider will then have
to find a new one and often that is difficult and expensive.

Drug resistance also means that over time some of the drugs used to treat AIDS
will no longer work for anyone. When this happens, there will no longer be
any form of treatment for AIDS.

Just as in adults, children need to take their medicine as directed in order to
stay healthy.
Ways of helping a child to adhere

Involving the child

Having a good relationship between the caregiver, child and their treatment
provider.

Finding out what beliefs a child has about HIV and ARV treatment, discussing
them and correcting any false information. This might involve addressing
specific issues, such as someone’s lack of trust in medication or beliefs that
ARVs are poisonous.

Providing clear and accurate information about HIV and ARVs that is
appropriate for a child’s specific needs. This includes: what treatment can and
cannot do; what to do about side effects; what to do to ensure adherence and
prevent drug resistance; and what happens if treatment has to be changed.

Providing a child with access to counselling and support from health workers
and other treatment supporters.

Regularly monitoring the progress of the treatment - through clinical checkups and asking specific questions about adherence.

Assessing and doing something about the child’s psychosocial concerns. These
might include: stress; depression; stigma and discrimination.

Having a personal treatment supporter

Involving a wide range of people – such as family, friends

Providing opportunities for the child to share their experiences with fellow
children who are taking ARVs successfully.

Providing methods to help a child remember especially those in boarding
schools
What can help a child who has difficulty with adherence to ARV treatment?

Having a non-judgemental approach and accepting that almost everyone
misses doses of drugs sometimes.

Assessing and building a child’s overall motivation for treatment.

Checking a child’s adherence by asking specific but open questions such as: “In
the last month, how many doses do you think you missed?”

Clarifying and checking a child’s understanding of their drug regimen.

Addressing a child’s patterns of non-adherence. For example, looking at
whether non-adherence is associated with particular social situations,
behaviours or thoughts.

Providing a child with additional support when needed – to help them
remember their doses, talk about their experiences and encourage them to
continue their treatment.

Use models of other children who are healthy as a result of taking their
medication well.
Asking someone to help remember

It helps to have someone to remind the child to take their drugs regularly.