Substance use and perceived barriers to antiretroviral therapy adherence among people living with HIV in Guangxi, China

Abstract

Objective: The aim of this study was to examine associations between nicotine, alcohol, and drug use, as well as key demographic variables, with barriers to antiretroviral therapy (ART) adherence among people living with HIV (PLHIV) in Guangxi, China.

Method: Cross-sectional survey data were obtained from 2,095 PLHIV in Guangxi, China, among whom 61.2% were male (n = 1283) and 38.8% were female (n = 812). Participants provided information on substance use history and four types of barriers to ART adherence (symptomatic, emotional, forgetful, and time management barriers). Multivariate regression was used to analyze associations between substance use and perceived barriers to adherence.

Results: A minority of participants reported current substance use, with 38.1% (n = 798) using nicotine, 30.7% (n = 644) using alcohol, and 6.6% (n = 138) using illicit drugs. A small but significant proportion of participants reported having quit nicotine, alcohol, and drug use following HIV diagnosis (10.0%, 8.5%, and 9.5%, respectively). Multivariate regression indicated that current drug use was associated with symptomatic, emotional, forgetful, and time management barriers to adherence; current alcohol use was associated with symptomatic, forgetful and time management barriers. Age, ethnicity, official residential status, employment status, duration of being on ART, ability to pay medical expenses, and perceived attitudes of healthcare providers were associated with one or more types of barriers.

Conclusions: Psychosocial and behavioral health interventions designed to improve ART adherence in China may benefit from incorporating substance use treatment and care for current users.

Keywords:

• Substance use
• antiretroviral therapy
• barriers
• people living with HIV
• China

Disclosure statement

No potential conflicts of interest was reported by the authors.

Additional information

Funding

The study was supported by the National Institute of Health (NIH) [grant number R01HD074221], National Natural Science Foundation of China [grant number 71673146 & 71203098], & Guangxi Commission on Health and Family Planning [grant number Z20170141]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NICHD or NSFC. All authors declare that they have no conflicts of interest.