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. 2025 Jan 24;25(1):313.
doi: 10.1186/s12889-025-21492-2.

The association between self-acceptance, emotion regulation, and treatment adherence self-efficacy among adolescents with HIV in Liangshan prefecture, China: a cross-sectional study

Dan Tan #  1 , Wenxi Zhong #  1 , Li Ma #  1 , Jing Cheng #  1 , Xianjun Mao #  1 , Xi Zhang #  1   2 , Jian Tang  3 , Song Fan  4 , Bianchuan Cao  5 , Yanhua Chen  6   7
Affiliations

The association between self-acceptance, emotion regulation, and treatment adherence self-efficacy among adolescents with HIV in Liangshan prefecture, China: a cross-sectional study

Dan Tan et al. BMC Public Health. .

Abstract

Background: Achieving viral suppression through effective treatment adherence is critical for adolescents with HIV; however, the role of treatment adherence self-efficacy-an individual's confidence in their ability to consistently follow antiretroviral therapy (ART) regimens-remains under-explored among Chinese adolescents. This gap is particularly concerning given the United Nations' "95-95-95" targets to end the AIDS epidemic by 2030.

Objective: The aim of this study is to investigate the treatment adherence self-efficacy levels of Yi ethnic adolescents with HIV in a county in Liangshan Prefecture, and to explore the association between self-acceptance, emotion regulation, and treatment adherence self-efficacy.

Methods: A cross-sectional study was conducted in a county of Liangshan Prefecture from November 2023 to March 2024. A convenience sampling method was used to select 205 participants. Multiple linear regression models were employed to examine the relationships between demographic variables, self-acceptance, emotion regulation and treatment adherence self-efficacy. A p-value < 0.05 was considered statistically significant.

Results: The study involved 205 participants (response rate: 96%) with an average age of 14.08 years. The mean ± standard deviation (SD) treatment adherence self-efficacy score of the study participants was 73.09 (± 16.37). Treatment adherence self-efficacy was significantly associated with factors such as residence [β = -0.174, 95% CI = (-13.841, -2.260)], occupation [β = 3.234, 95% CI = (7.061, 29.137)], and age [β = 0.312, 95% CI =(0.742, 2.502)]. In addition, self-acceptance and emotion regulation were positively correlated with treatment adherence self-efficacy. For each unit increase in self-acceptance, treatment adherence self-efficacy improved [β = 0.157; 95% CI =(0.081, 0.892)], and for each unit increase in emotion regulation, treatment adherence self-efficacy also improved [β = 0.314; 95% CI = (0.288, 0.724)].

Conclusions: This study highlighted that several factors, including place of residence, occupation, age, self-acceptance, and emotion regulation, were significantly associated with treatment adherence self-efficacy among adolescents with HIV. Notably, self-acceptance and emotion regulation were positively correlated with treatment adherence self-efficacy. Enhancing treatment adherence self-efficacy in this population could be achieved by focusing on improving self-acceptance and emotion regulation. Furthermore, interventions aimed at increasing treatment adherence self-efficacy should prioritize rural areas, non-student populations, and younger adolescents, as these groups tend to exhibit lower adherence self-efficacy. Tailored interventions that address the specific needs of these subgroups could contribute to improved health outcomes and more effective HIV management among adolescents.

Keywords: Adolescents with HIV; China; Mental health; Regression analysis; Self-efficacy.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the Ethics Committee of Southwest Medical University (Approval No. SWMUIRBTX-202403-0004). Informed consent was obtained from all participants prior to the start of the study. For participants under the age of 16, informed consent was also obtained from their legal guardians. All participants received detailed information about the study’s purpose, procedures, potential risks, and benefits. A comprehensive informed consent form highlighted that participation was voluntary and that participants could withdraw from the study at any time without any consequences. To ensure privacy and confidentiality, personal information was strictly protected, and all data were anonymized and used solely for academic purposes; any identifiable data were kept confidential to prevent the disclosure of participants’ identities. Due to the vulnerability of the participant group, psychological support and resources were provided to address any negative emotions or distress arising from participation. The research team employed appropriate measures throughout data collection to minimize any discomfort or harm. The study was designed to minimize potential risks and burdens to participants, with all procedures carefully developed to avoid physical or psychological harm, and comprehensive safety measures were implemented throughout the study. Consent for publication: Consent for publication was obtained from the participants and their legal guardians. Competing interests: The authors declare no competing interests.

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