Mental Health and ART Adherence in a Multisite International Study: The Mediating Roles of Social Support and Substance Use in People with HIV.

ART adherence, essential to preventing disease progression for people living with HIV (PLHIV), remains challenged by factors like poor mental health condition, insufficient social support, and substance use. This study investigates the roles of social support and substance use as mediators in the re...

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Publicado en:AIDS & Behavior pp. 1 - 17
Autores principales: Awad, Joseph, Sun, Wenxiu, Santa Maria, Diane, Schnall, Rebecca, Apiruknapanond, Panta, Wang, Tongyao, Valencia, Claudia Patricia, Horvat Davey, Christine, Solis Baez, Solymar, Iwu, Emilia, Sabone, Motshedisi, Makhado, Lufuno, Cuca, Yvette P., Phillips, J. Craig, Corless, Inge B., Shaibu, Sheila, Dawson-Rose, Carol, Chen, Wei-Ti
Formato: Journal Article
Publicado: Springer Nature Jan2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2026
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10461-025-04944-z
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        atl: Mental Health and ART Adherence in a Multisite International Study: The Mediating Roles of Social Support and Substance Use in People with HIV.
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          Awad, Joseph
          Sun, Wenxiu
          Santa Maria, Diane
          Schnall, Rebecca
          Apiruknapanond, Panta
          Wang, Tongyao
          Valencia, Claudia Patricia
          Horvat Davey, Christine
          Solis Baez, Solymar
          Iwu, Emilia
          Sabone, Motshedisi
          Makhado, Lufuno
          Cuca, Yvette P.
          Phillips, J. Craig
          Corless, Inge B.
          Shaibu, Sheila
          Dawson-Rose, Carol
          Chen, Wei-Ti
        affil: Department of Psychology, University of California Los Angeles
      sug:
      ab:
        ART adherence, essential to preventing disease progression for people living with HIV (PLHIV), remains challenged by factors like poor mental health condition, insufficient social support, and substance use. This study investigates the roles of social support and substance use as mediators in the relationship between mental health and antiretroviral therapy (ART) adherence among PLHIV in a multisite, international context. Cross-sectional data from <italic>N</italic> = 1598 PLHIV across eight countries were analyzed using parallel mediation analyses in R. Results indicated that both social support and substance use independently mediated the relationship between mental health and ART adherence. Hallucinogens mediated the mental health-adherence link. Cocaine, Amphetamine-type stimulants, inhalants, and opioids directly influenced adherence but did not mediate this relationship. In contrast, no significant effects were observed for tobacco, alcohol, cannabis or sedatives. This large-scale, nurse-led, international study offers critical insights into the roles of social support and substance use as psychosocial influencers in the cascade of care for PLHIV. Clinical implications include prioritizing educative, preventative, and harm-reductive approaches to specific substances that impact ART adherence. Findings may also inform interventions that emphasize strengthening social support to improve adherence in ART and care while addressing substance use as a barrier to care and well-being.
        Resumen: La adherencia al tratamiento antirretroviral (TAR), esencial para prevenir la progresión de la enfermedad en personas que viven con VIH (PVV), puede verse afectada por factores como salud mental alterada, apoyo social insuficiente y el consumo de sustancias. Este estudio investiga el comportamiento del apoyo social y el consumo de sustancias como mediadores en la relación entre la salud mental y la adherencia al TAR en unainvestigación internacional multicéntrica. Se analizaron datos de un estudio transversal con1598 PVV en ocho países mediante el análisis de la mediación paralela con el software R. Los resultados indicaron que tanto el apoyo social como el consumo de sustancias median de forma independiente, la relación entre salud mental y adherencia al TAR. Los alucinógenos mediaron el vínculo entre salud mental y adherencia. La cocaína, los estimulantes tipo anfetamina, los inhalantes y los opioides afectaron directamente la adherencia, pero no actuaron como mediadores. No se observaron efectos significativos para el tabaco, el alcohol, el cannabis ni los sedantes. Este estudio internacional, liderado por enfermeras, ofrece información crítica sobre los factores psicosociales que influyen en la cascada de atención para PVV. Las implicaciones clínicas incluyen priorizar enfoques educativos, preventivos y de reducción de daños sobre sustancias específicas que afectan la adherencia al TAR. Los hallazgos también sugieren intervenciones que fortalezcan el apoyo social para mejorar la adherencia al tratamiento y la atención, abordando el consumo de sustancias como una barrera al bienestar y la atención médica.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Unknown
    language: English
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