Table 5.
Regimen adherence questionnaire
1. How often do you feel that you have difficulty taking your HIV medications on time? By “on time” we mean no more than 2 hours before or 2 hours after the time your doctor told you to take it. ☐ All of the time ☐ Most of the time ☐ Rarely ☐ Never |
2. On average, how many days per week would you say that you missed at least one dose of your HIV medications? ☐ Every day ☐ 4 to 6 days/week ☐ 2 or 3 days/week ☐ Once a week ☐ Less than once a week ☐ Never |
3. When was the last time you missed at least one dose of your HIV medications? ☐ Within the past week ☐ 1 to 2 weeks ago ☐ 3 to 4 weeks ago ☐ Between 1 and 3 months ago ☐ More than 3 months ago ☐ Never |