AIDS and Behavior

, Volume 24, Issue 1, pp 45–54 | Cite as

HIV Disclosure to Family Members and Medication Adherence: Role of Social Support and Self-efficacy

  • Tianyue Mi
  • Xiaoming Li
  • Guangyu ZhouEmail author
  • Shan Qiao
  • Zhiyong Shen
  • Yuejiao Zhou
Original Paper


Although antiretroviral therapy (ART) is vital to people living with HIV (PLWH) by suppressing the virus and in turn preventing onward HIV transmission and reducing AIDS-related morbidity and mortality, the rates of optimal ART adherence continuously remain low. Disclosure of HIV status is considered to be a critical predictor of ART adherence. However, few studies have explored the mechanisms underlying the association between disclosure and medication adherence. The current study aims to examine the mediating role of social support and self-efficacy underlying the relationship between HIV disclosure to family members and ART adherence. PLWH in China provided data on HIV disclosure, ART adherence, perceived social support on medication adherence, adherence self-efficacy, and social-demographic information. The path analyses revealed that disclosure to family members had significant indirect effects on adherence via social support and self-efficacy. Our findings suggested that HIV disclosure might positively affect ART adherence through two psychosocial pathways: social support and self-efficacy. Future intervention to improve medication adherence among PLWH should consider targeting these two factors.


HIV/AIDS Disclosure ART Social support Self-efficacy 



The authors want to thank other team members at University of South Carolina and Guangxi CDC for their efforts in instrument development and data collection and data management.


The study was supported by National Institutes of Health (NIH) [Grant Nos. R01HD074221, R01AA018090 and R21AI122919] and National Nature Science Foundation of China (NSFC) [Grant No. 71673146]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or NSFC.

Compliance with Ethical Standards

Conflict of interest

Authors declare no of conflict of interest.

Ethical Approval

The study protocol received review and approval from the Institutional Review Boards at Guangxi CDC in China and Wayne State University in the United States.

Informed Consent

Informed consent was obtained from all participants included in the study.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental HealthPeking UniversityBeijingChina
  2. 2.Department of Health Promotion, Education, and Behavior & South Carolina SmartState Center for Healthcare Quality (CHQ)University of South Carolina Arnold School of Public HealthColumbiaUSA
  3. 3.Guangxi Center for Disease Control and PreventionNanningPeople’s Republic of China

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