Consequences of Non- adherence

Why is near-perfect adherence important?

  1. To ensure that ART and other medications do their job
  2. To increase the CD4 cell count and decrease the amount of HIV in the body
  3. To avoid the HIV becoming resistant to certain medicines
  4. To make sure people get all the benefits that medicines for opportunistic infections and ARVs have to offer, such as feeling better, not getting Opportunistic Infections, etc.
  5. To prevent mother-to-child transmission of HIV
  6. To monitor people’s health and also help them find community support resources
  7. To keep people looking and feeling good so they can get back to normal life
  8. To prevent sickness and death
  9. To keep families, communities and our nation healthy and productive

What happens when a person does not adhere?

  1. The levels of drugs in the body drop and HIV keeps multiplying.
  2. A mother is more likely to pass HIV to her child during pregnancy, delivery or breastfeeding.
  3. The CD4 cell count will drop and the person will start getting more OIs.
  4. Children in particular will become ill very quickly.
  5. The person’s HIV can develop resistance to one or all of the drugs, meaning that the drugs will not work anymore even if they are taken correctly again. We can say that HIV is a very “intelligent” virus – it only takes a couple of missed doses for it to learn how to be stronger than the ARVs, to multiply and take over the body again.
  6. The ARV combination the person was originally taking will not work anymore and the person may have to start taking a new regimen or second-line ARVs (but there might not be many kinds of these ARVs available). So poor adherence can decrease future treatment options.

Remember: Development of drug resistance must be avoided at all costs.

There are not many other drug options if people develop resistance to the drugs they are started on!


  1. The Comprehensive Peer Educator Training Curriculum: Trainer Manual International Center for AIDS Care and Treatment Programs, Columbia University