Research has established that non-adherence to the antiretroviral drugs medication of up to 95 % can have adverse effects in relation to preventing the replication of the virus. Non-adherence may also lead to the mutation of the virus, to strains that are more resistant to the antiretroviral drugs. Therefore, as outlined by Morris (2009) adherence to medication is important in the prevention of opportunistic infections caused by compromised immune system. The ability of the virus to develop resistance to a particular antiretroviral treatment may have the consequence of the patient, not being able to respond to all drugs that have the same mechanism of action. The effective use of antiretroviral drugs has become an important aspect in the management of HIV. In the 1990s the discovery of the Highly Active Anti-retroviral Therapy (HAART), was a huge leap ahead towards the fight against HIV. This is in consideration with the fact by 2007 nearly 36.1 million people in the world had already been infected with HIV. Mostly in third world countries, infections are unrecorded due to inaccessibility of health care. Therefore, according to Jurgen (2008) it is obvious that the number is much bigger.  

According to Walker (2010), clinicians have invented various methodologies, for instance the Anti-retroviral therapy methodology attempting to manage HIV. Anti-retroviral attempts to bring back to normal all the processes of the body affected by HIV; the physiological and the psychological in order to arrive at overall health success. In recent times there has been a subtle war against the use anti-retroviral therapy claiming that using anti-retroviral is a too complex and expensive for average citizens particularly in third world countries. The health care has recorded considerable success with over 60 percent of patients using anti-retroviral in the U.S alone; the patients using the therapy have also confessed success. However some countries, especially the third world countries, have expressed discontent that the anti-retroviral therapy is too expensive because of the cost of the drugs.

Concern over the constant challenges faced by health care or health managers is growing exponentially; this fact has subsequently led to a quest by many for an all rounded health management strategy with the capacity to provide both guidance and solution to the challenges. Health strategy is the secret behind any successful health care system. However there are many different types of strategies with varied approaches and therefore it becomes difficult for the management of a hospital when choosing which strategy or strategies to adopt. The most important factor to consider when choosing a strategy should be the one with the capacity to stand the constant health challenges while at the same time giving the health the power to grow. Felipe (2006) explains that the essence of using anti-retroviral is to provide health in both physiological and psychological condition of patients.

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