title: 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.
authors.affiliation: a The Carman and Ann Adams Department of Pediatrics , Wayne State University School of Medicine , Detroit , MI , USA.
authors.forename: Liying
authors.initials: L
authors.lastname: Zhang
authors.affiliation: a The Carman and Ann Adams Department of Pediatrics , Wayne State University School of Medicine , Detroit , MI , USA.|b Arnold School of Public Health , University of South Carolina , Columbia , SC , USA.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.affiliation: a The Carman and Ann Adams Department of Pediatrics , Wayne State University School of Medicine , Detroit , MI , USA.|c Center for Health Policy Research , Nanjing Medical University , Nanjing , People's Republic of China.
authors.forename: Zhenping
authors.initials: Z
authors.lastname: Lin
authors.affiliation: a The Carman and Ann Adams Department of Pediatrics , Wayne State University School of Medicine , Detroit , MI , USA.
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Jacques-Tiura
authors.affiliation: d Department of Family Medicine and Public Health Sciences , Wayne State University School of Medicine , Detroit , MI , USA.
authors.forename: Jinping
authors.initials: J
authors.lastname: Xu
authors.affiliation: e Guangxi Center for Disease Control and Prevention , Nanning , People's Republic of China.
authors.forename: Yuejiao
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: a The Carman and Ann Adams Department of Pediatrics , Wayne State University School of Medicine , Detroit , MI , USA.|b Arnold School of Public Health , University of South Carolina , Columbia , SC , USA.
authors.forename: Shan
authors.initials: S
authors.lastname: Qiao
authors.affiliation: e Guangxi Center for Disease Control and Prevention , Nanning , People's Republic of China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Shen
authors.affiliation: a The Carman and Ann Adams Department of Pediatrics , Wayne State University School of Medicine , Detroit , MI , USA.
authors.forename: Bonita
authors.initials: B
authors.lastname: Stanton
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D020380:Needs Assessment; D020377:Self Efficacy; D016903:Drug Monitoring
keywords: Adherence; China; HIV infection; adherence self-efficacy; antiretroviral therapy (ART); side effects