Video: Janelle's Adherence Counseling
Janelle is a 17-year-old African American with perinatally acquired HIV. Her mother is deceased, and she lives with her grandmother and younger siblings. Janelle has been on numerous ARV regimens in the past, but for 2 years she has been stable on lopinavir/ritonavir (twice daily) and abacavir/lamivudine (Epzicom) taken once daily.
Three months ago, she had an undetectable viral load, but it was measured at 4,000 copies/mL at her most recent visit. When Janelle returned for her lab results, she reported taking 26 of 28 medication doses since her previous visit.
Because of the spike in Janelle's viral load, her provider, Dr. Rollins, ordered another viral load test, which measured 8,000 copies/mL. When Janelle returned for the results of the second test, she again claimed good adherence. However, a genotypic assay found several new resistance mutations. Dr. Rollins also ordered a test of Janelle's serum lopinavir level, which was undetectable.