Zhou Guangyu, Li Xiaoming, Qiao Shan, Zhou Yuejiao, Shen Zhiyong
a Department of Health Promotion, Education, and Behavior & South Carolina SmartState Center for Healthcare Quality (CHQ) , University of South Carolina Arnold School of Public Health , Columbia , SC , USA.
c School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health , Peking University , Beijing , People's Republic of China.
AIDS Care. 2017 Dec;29(12):1533-1537. doi: 10.1080/09540121.2017.1327648. Epub 2017 May 11.
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.
在全球范围内，尽管最佳抗逆转录病毒疗法（ART）依从性对于艾滋病毒感染者（PLWH）获得最大临床益处和治疗成功至关重要，但目前仍未达到理想水平。已有证据表明，许多因素会影响药物依从性，包括感知到的障碍和自我效能感。然而，关于中国ART依从性的心理和行为障碍的数据有限。此外，很少有研究探讨这两个因素影响艾滋病毒药物依从性的机制。本研究的目的是检验依从性自我效能感在PLWH感知到的障碍与ART依从性之间的中介作用。横断面数据来自中国广西的2095名PLWH，他们提供了ART依从性数据。参与者报告了他们的药物依从性、自我效能感、ART依从性障碍以及背景特征。结果表明，通过依从性自我效能感，感知到的障碍对药物依从性有显著的间接影响。对ART依从性较高的心理和行为障碍感知与较低的依从性自我效能感相关，而这又与较低的ART依从性相关。自我效能感可以缓冲感知到的障碍对ART依从性的负面影响。建议未来促进艾滋病毒药物依从性的干预措施应侧重于消除心理和行为障碍，以及提高依从性自我效能感。
