Therapeutic approach to noncompliance in HIV care.

Clinical scenario A fourth-year medical student interested in HIV has joined you in the clinic this afternoon. The last time he was there, you asked him to find out the latest statistics on HIV in Canada. Are rates rising or falling? What are the trends in terms of age groups and exposure categories? The student reports that he has researched your questions. You note there is a 34-year-old male patient with HIV waiting to see you, and you recall he missed his last appointment. You suggest the student see your patient first and then you will discuss the statistics and the case. He sees the patient and comes into your office visibly frustrated. He tells you that the man has not been taking treatment for about 2 months now. Worse, he seems to be using street drugs. The student is estimating the effect this will have on his viral load. What will your therapeutic approach with your patient be and how might you turn this into a learning opportunity for your student? Therapeutic approach to noncompliance in HIV care