Psychological and behavioral barriers to ART adherence among PLWH in China: role of self-efficacy

ABSTRACT

Globally, optimal adherence to antiretroviral therapy (ART) is insufficient despite it is critical for maximum clinical benefits and treatment success among people living with HIV (PLWH). Many factors have been evidenced to influence medication adherence, including perceived barriers and self-efficacy. However, limited data are available regarding to psychological and behavioral barriers to ART adherence in China. Moreover, few studies have examined the mechanism of these two factors underlying HIV medication adherence. The aim of the current study is to examine the mediating role of adherence self-efficacy between perceived barriers and ART adherence among PLWH. Cross-sectional data were obtained from 2095 PLWH in Guangxi China who provided data on ART adherence. Participants reported their medication adherence, self-efficacy, barriers to ART adherence, as well as background characteristics. Results indicated a significant indirect effect from perceived barriers to medication adherence through adherence self-efficacy. Higher perceived psychological and behavioral barriers to ART adherence were related to lower adherence self-efficacy, which in turn was related to lower ART adherence. Self-efficacy could buffer the negative effects of perceived barriers on ART adherence. Future interventions to promote HIV medication adherence are recommended to focus on eliminating psychological and behavioral barriers, as well as increasing adherence self-efficacy.

KEYWORDS:

• Antiretroviral therapy (ART) adherence
• adherence self-efficacy
• perceived barriers
• people living with HIV (PLWH)
• China

Acknowledgements

The authors want to thank other team members at University of South Carolina and Guangxi CDC for their efforts in instrument development and data collection and data management.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Guangyu Zhou http://orcid.org/0000-0003-2053-6737

Additional information

Funding

The study was supported by National Institutes of Health (NIH) [grant number R01HD074221] and [grant number R01AA018090] and National Nature Science Foundation of China (NSFC) [grant number 71673146]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or NSFC.