Nine Pints: A Journey Through the Money, Medicine, and Mysteries of Blood

by Rose George

Adults are getting tired of taking drugs, especially when they feel well. Children who grew up with HIV who become adolescents do what teenagers do: they rebel. They stop taking their drugs. It is horribly easy, as MSF pediatrician Ann Moore explains to me later, to create resistance. To protect against resistance, anyone on ARVs must take them 95 percent of the time. I ask her to translate this into doses. Does that mean missing a few doses? No, she says. It means you can risk missing only one a month. This is chilling. Who has never cut short a course of antibiotics or skipped some tablets? Missing one dose a week is a reduction of 12 percent, so a definite danger zone. She tries to explain how this works biologically—it has to do with how the virus mutates—but if I find it taxing, I wonder how they convey that to a teenager. Probably this is why the message to the newly HIV-positive can perhaps seem blunt: take your ARVs, every day, always and forever.