Compliance

Earlier this year the government supplied HIV medications were in short supply.  Rather than getting their normal 1-2 months of medications patients received only 3-14 days of medication and occasionally none.  This required more frequent trips to pick up medication with obvious increased time and transportation costs for the patient.  At the time I wondered what effect the shortages would have on the patients compliance long term.  

Today 53 year old William presented with 2 months of fever, cough and diarrhea. William has HIV and had been on HIV medications since 2008. He had been very faithful about collecting his medications monthly. In January when he came in there were no medications available and he was told to come back in 1 week and see if we had any then. William never returned until his illness today. Did he initially notice no change in how he felt off his medications? Did he figure if we had no medications it was no longer important to take them. Regardless, every month he missed made it more difficult to come in and explain his absences. William will hopefully recover from his present illness which may be TB. His HIV may be now resistant to his prior medications. If that is the case we have only one medication left to give him.