Clinical outcomes, emotional management, and medicine adherence among HIV patients in China

Background: Limited empirical studies focus on the role of emotional management in ART adherence. In addition, the findings are mixed about the association between patients’ self-report ART adherence and their clinical outcomes. We aim to examine the relationships between clinical outcomes, emotional management and medicine adherence among HIV patients in China.

Method: The data was collected by 6-month follow-up survey of a longitudinal RCT initiated in 2013 among 796 HIV-positive parents in Guangxi, China. A total of 447 participants receiving ART completed the survey including demographics, mental health, and medicine adherence. The clinical outcomes were retrieved from medical records after consents. Participants who took ART medicine as prescribed at least 27 days in past 30 days were categorized as high adherence group, otherwise they were in low adherence group. Descriptive analysis and GLM were employed in data analysis.   

Results: The multivariate test indicated that ART adherence was significantly associated with clinical outcomes and emotional management (F=14.367, p<.001). Univariate tests suggested that medicine adherence was positively associated with CD4 (F=18.353, p<.001), negatively associated with virus loading (F=24.903, p<.001), and negatively associated with emotional management difficulties (F=6.301, p=.012).

Discussion: Our findings confirm that self-reported ART adherence could be highly consistent with clinical outcomes among HIV patients in China. It is rarely explored but notable that emotional management problems may be a barrier to ART adherence for HIV patients. In the era when HIV/AIDS has been transforming from fatal disease to chronic one, emotional management could be a necessary component for patients’ self-management and self-care.