Substance use, anxiety, and self-management efficacy in HIV-positive individuals: A mediation analysis

ABSTRACT

Context: In China, the social stigma of both substance use and HIV remains major barrier. HIV-positive individuals have been demonstrated to have higher psychosocial distress in the literature. To ensure quality of life among HIV-positive Chinese individuals, self-efficacy in HIV-related management including substance use and anxiety is the key to suppress viral load and maintain healthy lives. Objectives: We examine the mediation relationship among substance use, anxiety, and self-management efficacy. Method: A cross-sectional study design was used. In total, 137 HIV-positive individuals were recruited from two premier Chinese hospitals: Beijing’s Ditan Hospital and Shanghai’s Public Health Clinic Center (SPHCC). Results: HIV-positive substance users had significantly lower HIV-management efficacy and higher anxiety scores. About a third of the relations between substance use and anxiety were mediated by HIV-management self-efficacy. Those who used substances in the previous week had higher anxiety levels suggesting the presence of a recency effect. Their higher levels of anxiety could be largely explained by their lower HIV-management efficacy. Conclusion: It is useful for healthcare providers to assess substance use behaviors in HIV-positive individuals as well as provide support in managing anxiety in this population. Meanwhile, enhancing self-management efficacy to ensure healthy lifestyles may support achieving optimal lives with HIV.

KEYWORDS:

• Substance use
• China
• HIV
• anxiety
• self-management

Acknowledgments

We gratefully acknowledge all the study participants, without them, it is not possible to complete these projects.

Disclosure of potential conflicts of interest

No conflict of interest has been declared by the authors.

Additional information

Funding

This work was supported by NINR [grant number K23NR14107 to C. Wei-Ti]