The moderating effect of HIV-stigma on the relationship between sources of perceived social support and self-efficacy among adult patients living with HIV, in KwaZulu-Natal, South Africa.

Abstract

BACKGROUND:For people living with HIV (PLWH), treatment adherence self-efficacy is considered as a critical predictor of psychosocial well-being and adherence to antiretroviral therapy (ART). Through previous studies social support and HIV-stigma have been noted to be independently linked with adherence to ART among adult PLWH. However, the process through which the HIV-stigma moderate the relationship between sources of perceived social support and HIV adherence self-efficacy is not fully known. Therefore, the study investigated whether the relationship between sources of perceived social support and HIV adherence self-efficacy is moderated by HIV-stigma. METHODS:The study was conducted between October andNovember 2020at King Edward VIII hospital based in Umbilo Durban, KwaZulu-Natal, South Africa. Using a cross-sectional survey design a total of 201 adult patients 71% (n=142) female and 29% (n=59) male, aged 18-75 years receiving ART completed a self-administered questionnaire measuring self-efficacy (Adherence Self-Efficacy Scale [ASES]), social support (Multidimensional Perceived Social Support [MPSS]), and HIV-stigma (Short Version of HIV Stigma Scale [HSS]). The data were analysed using hierarchical multiple regression analyses through SPSS version 27. RESULTS:The results showed that treatment adherence self-efficacy was significantly and positively predicted by social support from family (r= .47, p <0001) friends (r= .37, p <0001), and significant other (r= .35 , p <0001) Furthermore, the results of hierarchical moderated regression analyses indicated that HIV-stigma moderated the direct relationship of social support and self-efficacy from both sources of support namely family (B= -0.027, t= -2.58, p <.011) and friend (B= -0.029, t= -2.65, p <009). The analyses also revealed that the relationship between social support from significant other and self-efficacy was not moderated by HIV-stigma (B= -0.004, t= -0.351, p >.726). CONCLUSIONS:The findings suggested that the sources of social support remain an invaluable resource to bolster treatment adherence self-efficacy among PLWH, however the future interventions should also consider targeting HIV-stigma to improve adherence to ART among this population.