Enhanced Adherence Counselling (EAC) & Support
Clinician considerations for providing Enhanced Adherence Counselling (EAC) Barrier to adherence Intervention EAC indicated? Difficulty getting to facility to collect treatment Reduce unnecessary visits through enrolling client in a RPCs model or providing multi-month dispensing (MMD) No need for EAC Drug side effects or unpalatability impacting adherence? Change to more palatable regimen No need
Clinician considerations for providing Enhanced Adherence Counselling (EAC)
| Barrier to adherence | Intervention | EAC indicated? |
| Difficulty getting to facility to collect treatment | Reduce unnecessary visits through enrolling client in a RPCs model or providing multi-month dispensing (MMD) | No need for EAC |
| Drug side effects or unpalatability impacting adherence? | Change to more palatable regimen | No need for EAC |
| Challenges with taking/remembering to take treatment | Provide EAC | |
Enhanced Adherence Support
Enhanced Adherence Counselling (EAC) is aimed at non-stable clients presenting with adherence issues or poor treatment response and/or signs of treatment failure. Enhanced Adherence Counselling focuses on:
- Providing education on the outcome of their latest clinical assessment and VL results
- Understanding what the client already knows or doesn’t know regarding their treatment and the importance of VL suppression
- Doing a mental health screen
- Correcting any misconceptions and allowing flexibility around the most common barriers to adherence (such as alcohol/ drug consumption, forgetting doses due to a rigid schedule, etc.)
- Assessing and understanding the barriers that affect the client’s adherence
- Developing adherence strategies to overcome these
'Better late than never' clients should be counselled they can take their ARVs up to several hours late if they miss their chosen time
To support the above processes, the following useful tools extracted from the Differentiated Care Models Standard Operating Procedures 2023 included in the annexures:
- SOP 2 Enhanced Adherence Counselling (Annexure 3)
- Mental Health Screen (Annexure 4)
- Child and adolescent disclosure counseling for children living with HIV (Annexure 7)
2023 ART Clinical Guidelines for the Management of HIV in Adults, Pregnancy and Breastfeeding, Adolescents, Children, Infants and Neonates
June 2023 Version 4
Upload date: 04/08/2023