Side effects, adherence self-efficacy, and adherence to antiretroviral treatment: a mediation analysis in a Chinese sample

ABSTRACT

Antiretroviral therapy (ART) is a lifelong treatment. To date, ART adherence is suboptimal for most patients in resource-poor settings. Previous research indicates that medication side effects are perceived to be a significant barrier of high ART adherence. Data regarding the role of adherence self-efficacy in mediating the relationship between side effects from ART and adherence to ART are limited; thus, this study examines this potential mediational role of self-efficacy. A cross-sectional survey of 2987 people living with HIV aged ≥18 years was conducted in 2012–2013 in Guangxi Autonomous Region (Guangxi) which has one of the fastest-growing HIV rates in China. Of the total sample, 2146 (72.1%) participants had initiated ART. Participants reported the number of days of completing the daily dose of ART in the past month; adherence was defined as completing the daily dose at least 28 days in the last month (≥90%). Side effects were significantly negatively related to adherence to ART. Mediation analyses indicated that adherence self-efficacy significantly mediated the side effects–adherence relationship. Future interventions to increase adherence self-efficacy and effective coping with side effects among HIV patients are needed in order to improve their ART adherence.

KEYWORDS:

• Adherence
• adherence self-efficacy
• antiretroviral therapy (ART)
• side effects
• HIV infection
• China

Acknowledgements

The authors want to thank local team members at Guangxi CDC for their efforts in instrument development and data collection.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The study was supported by National Institutes of Health (NIH) [grant numbers R01HD074221 and R01AA018090] and National Natural Science Foundation of China (NSFC) [grant number 71203098]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or NSFC.