Sociodemographic and psychosocial factors influencing adherence to antiretroviral treatment (ART) among people living with HIV in Southeast China

Background:

Antiretroviral treatment (ART) adherence predicts progression to AIDS. Studies show that psychosocial factors were consistently associated with poor adherence. Limited data are available among people living with HIV (PLWH) in China. The purpose of this study is to examine the associations between psychosocial factors (adherence self-efficacy, medication social support, psychological distress) and ART adherence among PLWH in China.

Methods: A cross-sectional survey of 2,987 PLWH aged > 18 years was conducted in 2012 in Guangxi Autonomous Region (Guangxi) which has the fastest-growing HIV epidemic in China. ART adherence was measured using one item with a question that “In the last month, how many days did you use the complete regime of ART medication?” Self-efficacy of medication adherence was measured using 12 items (alpha=0.918).      

Results: Mean age of the sample was 42.45 years (SD=12.83). Of the 2,987 respondents, 62.8% (n=1,876) were male. 72.1% (n=2,146) of them had initiated utilization of ART. Among those participants who utilized ART, 1,685 (79.8%) reported using ART every day in the last month. Multivariate logistic regression analysis results showed that adherence self-efficacy was significantly positively associated with ART adherence (p<0.01). Age, religion, income and experience of side effect were also significantly associated with ART adherence (p<0.01). Other psychological distress factors including anxiety and depression, drug use, social support, internalized stigma did not show statistical significance.

Conclusions: Adherence self-efficacy predicts ART adherence among people living with HIV in China. Results suggested that the potential of mental health intervention need to increase patients’ self-efficacy of medication adherence.