You are more likely to adhere to your HIV treatments if you were involved in the decisions about both when to start treatment and about which drugs to start treatment with.

Being honest about your lifestyle to yourself and to your doctor can help ensure that you start on a combination that is right for you. Don’t make unrealistic demands on yourself, and think about how taking medication will fit in with your social, working, eating and sleeping patterns. The chances are that there will be a combination available that will mean that you don’t have to change your lifestyle at all, or make only modest alterations to your routine.

Side-effects are a very common reason why people skip doses. If you are experiencing side-effects of any kind, make sure you tell your doctor. The chances are that there will be another treatment option available. It’s better to change treatments than miss doses and risk resistance.

Taking handfuls of pills is often cited by people as a reason why they miss doses. Doctors call the number of pills you have to take your ‘pill burden'. If you find taking lots of pills a problem, then talk to your doctor about taking a combination with as few pills as possible. It might be that you can switch to a combination that involves taking no more than a couple of pills twice a day. And it's good to know that triple anti-HIV treatment that consists of just one pill, once a day is now available (Atripla). But make sure that you consider how these ‘easy to take’ regimens fit in with the reality of your day-to-day life.

Depression and other emotional and mental health problems have been linked with low levels of adherence. If you’re depressed and don’t think that you can cope with starting HIV treatments, then it might be best to wait until you feel more able to cope. Similarly, if you become depressed whilst taking treatments, it’s important to seek help. Depression is very common in people with HIV (see the chapter on Mental health), and many HIV clinics have specialist mental health teams who can offer treatment and support. Treatments for depression work just as well in HIV-positive people.

Having problems with money and housing, and feeling isolated, have also been known to be associated with low levels of adherence in some people. Many HIV organisations can provide advice about money and accommodation, and your HIV clinic may even have a specialist HIV social worker you can see for advice. If you have family or friends who know that you are taking HIV-medication, try and talk to them about the problems you are experiencing – you might find that they are able to offer wonderful support. On the other hand, if you are worried about people close to you knowing that you have HIV, you might find that one solution is an adherence support group involving other HIV-positive people. These are organised by many HIV clinics and HIV support agencies.