Factors involved between social support and self-efficacy in HIV-infected individuals

Wendel Mombaque dos Santos, Stela Maris de Mello Padoin, Tânia Solange B. de Souza Magnago, Graziele de Lima Dalmolin, Samuel Spierlberg Zuge


Aims: To investigate the relationships between perceived social support received and expectation of self-efficacy.

Methods: Cross-sectional study conducted at the Outpatient Clinic of Infectious Diseases of the Teaching Hospital of Santa Maria, southern Brazil, from January to July 2012 with adults on antiretroviral treatment for HIV. To collect the data, we applied an instrument which included: a sociodemographic and economic questionnaire, a self-efficacy expectation scale for antiretroviral treatment, and the scale for evaluation of social support. We used descriptive statistics, Spearman’s correlation, and multivariate logistic regression. Values equal to or less than 5% were considered to be of statistical significance.

Results: There was a correlation between emotional social support and expectation of self-efficacy. Total social support presented CD4+ T lymphocyte count  up to 50 cells/µL (odds ratio [OR] = 1.17; 95% confidence interval [CI] = 1.01-1.37) as a risk factor, and an income of less than 8,000 dollars per year (OR = 0.95; 95%CI = 0.91-0.99) as a protective factor. Four to seven years of schooling (OR = 0.94; 95%CI = 0.89-0.99), income of less than 8,000 dollars per year (OR = 0.91; 95%CI = 0.84-0.98), CD4+ T lymphocyte count up to 50 cells/µL (OR = 0.84; 95%CI = 0.77-0.92), viral load equal to or greater than 501 copies/mL (OR =0.91; 95%CI=0.87-0.95), and healthcare follow-up considered moderate (OR = 0.96; 95%CI = 0.92-0.99) or difficult (OR = 0.94; 95%CI = 0.89-0.99) were regarded as protective factors for self-efficacy.

Conclusions: Perceived social support is associated with expectation of self-efficacy. The data suggest that social support and expectation of self-efficacy, in addition to affecting the therapeutic response to treatment, may interfere with healthcare follow-up and act as a protective factor for sustained adherence to antiretroviral therapy.


HIV infections; anti-retroviral agents; social support; self efficacy.


World Health Organization. Global report: UNAIDS report on the global AIDS epidemic 2013. Geneva: UNAIDS; 2013.

Brasil. Boletim epidemiológico - Aids e DST. Brasília: Ministério da Saúde - Secretaria de Vigilância em Saúde; 2013.

Lombardo PG, Costa Aguiar BG. Envejeciendo con AIDS o el AIDS en el envejecimiento: perfil epidemiológico en un hospital de la Universidad de Rio de Janeiro. Enfermería Glob. 2012;11:10-20. http://dx.doi.org/10.4321/S1695-61412012000200002

Wasti SP, van Teijlingen E, Simkhada P, Randall J, Baxter S, Kirkpatrick P, Gc VS. Factors influencing adherence to antiretroviral treatment in Asian developing countries: a systematic review. Trop Med Int Health. 2012 Jan;17(1):71-81. http://dx.doi.org/10.1111/j.1365-3156.2011.02888.x

Parienti JJ, Bangsberg DR, Verdon R, Gardner EM. Better adherence with once-daily antiretroviral regimens: a meta-analysis. Clin Infect Dis. 2009 Feb 15;48(4):484-8. http://dx.doi.org/10.1086/596482

Merten S, Kenter E, McKenzie O, Musheke M, Ntalasha H, Martin-Hilber A. Patient-reported barriers and drivers of adherence to antiretrovirals in sub-Saharan Africa: a meta-ethnography. Trop Med Int Health. 2010 Jun;15 Suppl 1:16-33. http://dx.doi.org/10.1111/j.1365-3156.2010.02510.x

Remor E. Systematic review of the psychometric properties of the questionnaire to evaluate the adherence to HIV therapy (CEAT-VIH). Patient. 2013;6(2):61-73. http://dx.doi.org/10.1007/s40271-013-0009-0

Chesney MA, Ickovics JR, Chambers DB, Gifford AL, Neidig J, Zwickl B, Wu AW. Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. Patient Care Committee & Adherence Working Group of the Outcomes Committee of the Adult AIDS Clinical Trials Group (AACTG). AIDS Care. 2000 Jun;12(3):255-66. http://dx.doi.org/10.1080/09540120050042891

Ironson G, Hayward H. Do positive psychosocial factors predict disease progression in HIV-1? A review of the evidence. Psychosom Med. 2008 Jun;70(5):546-54. http://dx.doi.org/10.1097/PSY.0b013e318177216c

Smith R, Rossetto K, Peterson BL. A meta-analysis of disclosure of one's HIV-positive status, stigma and social support. AIDS Care. 2008 Nov;20(10):1266-75. http://dx.doi.org/10.1080/09540120801926977

Wolf MS, Davis TC, Osborn CY, Skripkauskas S, Bennett CL, Makoul G. Literacy, self-efficacy, and HIV medication adherence. Patient Educ Couns. 2007 Feb;65(2):253-60. http://dx.doi.org/10.1016/j.pec.2006.08.006

Swendeman D, Ingram BL, Rotheram-Borus MJ. Common elements in self-management of HIV and other chronic illnesses: an integrative framework. AIDS Care. 2009 Oct;21(10):1321-34. http://dx.doi.org/10.1080/09540120902803158

Leite JC, Drachler ML, Centeno MO, Pinheiro CA, Silveira VL. Desenvolvimento de uma escala de auto-eficácia para adesão ao tratamento anti-retroviral. Psicol Reflex Crit. 2002;15:121-33. http://dx.doi.org/10.1590/S0102-79722002000100014

Seidl EM, Tróccoli BT. Desenvolvimento de escala para avaliação do suporte social em HIV/aids. Psic Teor e Pesq. 2006;22:317-26. http://dx.doi.org/10.1590/S0102-37722006000300008

Bekele T, Rourke SB, Tucker R, Greene S, Sobota M, Koornstra J, Monette L, Rueda S, Bacon J, Watson J, Hwang SW, Dunn J, Guenter D; Positive Spaces Healthy Places Team. Direct and indirect effects of perceived social support on health-related quality of life in persons living with HIV/AIDS. AIDS Care. 2013;25(3):337-46. http://dx.doi.org/10.1080/09540121.2012.701716

Colbert AM, Kim KH, Sereika SM, Erlen JA. An examination of the relationships among gender, health status, social support, and HIV-related stigma. J Assoc Nurses AIDS Care. 2010 Jul-Aug;21(4):302-13. http://dx.doi.org/10.1016/j.jana.2009.11.004

Cha E, Erlen JA, Kim KH, Sereika SM, Caruthers D. Mediating roles of medication –taking self-efficacy and depressive symptoms on self-reported medication adherence in persons with HIV: a questionnaire survey. Int J Nurs Stud. 2008 Aug;45(8):1175-84. http://dx.doi.org/10.1016/j.ijnurstu.2007.08.003

Johnson MO, Neilands TB, Dilworth SE, Morin SF, Remien RH, Chesney MA. The role of self-efficacy in HIV treatment adherence: validation of the HIV Treatment Adherence Self-Efficacy Scale (HIV-ASES). J Behav Med. 2007 Oct;30(5):359-70. http://dx.doi.org/10.1007/s10865-007-9118-3

Chesney MA, Neilands TB, Chambers DB, Taylor JM, Folkman S. A validity and reliability study of the coping self-efficacy scale. Br J Health Psychol. 2006 Sep;11(Pt 3):421-37. http://dx.doi.org/10.1348/135910705X53155

Colombrini MR, Coleta MF, Lopes MH. Fatores de risco para a não adesão ao tratamento com terapia antiretroviral altamente eficaz. Rev Esc Enferm USP. 2008 Sep;42(3):490-5. http://dx.doi.org/10.1590/S0080-62342008000300011

López LC. Uma análise das políticas de enfrentamento ao HIV/Aids na perspectiva da interseccionalidade de raça e gênero. Saúde Soc. 2011;20:590-603. http://dx.doi.org/10.1590/S0104-12902011000300006

Kalichman SC, Ramachandran B, Catz S. Adherence to combination antiretroviral therapies in HIV patients of low health literacy. J Gen Intern Med. 1999 May;14(5):267-73. http://dx.doi.org/10.1046/j.1525-1497.1999.00334.x

Casale M, Wild L, Kuo C. "They give us hope": HIV-positive caregivers' perspectives on the role of social support for health. AIDS Care. 2013;25(10):1203-9. http://dx.doi.org/10.1080/09540121.2013.763893

Bogart LM, Cowgill BO, Kennedy D, Ryan G, Murphy DA, Elijah J, Schuster MA. HIV-related stigma among people with HIV and their families: a qualitative analysis. AIDS Behav. 2008 Mar;12(2):244-54. http://dx.doi.org/10.1007/s10461-007-9231-x

Yang LH, Kleinman A. 'Face' and the embodiment of stigma in China: the cases of schizophrenia and AIDS. Soc Sci Med. 2008 Aug;67(3):398-408. http://dx.doi.org/10.1016/j.socscimed.2008.03.011

Corrigan PW, Watson AC. The Paradox of self-stigma and mental illness. Clin Psychol (New York). 2002;9(1):35-53. http://dx.doi.org/10.1093/clipsy.9.1.35

Kelly JD, Hartman C, Graham J, Kallen MA, Giordano TP. Social Support as a Predictor of Early Diagnosis, Linkage, Retention, and Adherence to HIV Care: Results From The Steps Study. J Assoc Nurses AIDS Care. 2014 Sep-Oct;25(5):405-13. http://dx.doi.org/10.1016/j.jana.2013.12.002

Aragonés C, Sánchez L, Campos JR, Pérez J. Antiretroviral therapy adherence in persons with HIV/AIDS in Cuba. MEDICC Rev. 2011 Apr;13(2):17-23.

Cooper V, Gellaitry G, Hankins M, Fisher M, Horne R. The influence of symptom experiences and attributions on adherence to highly active anti-retroviral therapy (HAART): a six-month prospective, follow-up study. AIDS Care. 2009 Apr;21(4):520-8. http://dx.doi.org/10.1080/09540120802301824

Govindasamy D, Ford N, Kranzer K. Risk factors, barriers and facilitators for linkage to antiretroviral therapy care: a systematic review. AIDS. 2012 Oct 23;26(16):2059-67. http://dx.doi.org/10.1097/QAD.0b013e3283578b9b

Liu L, Pang R, Sun W, Wu M, Qu P, Lu C, Wang L. Functional social support, psychological capital, and depressive and anxiety symptoms among people living with HIV/AIDS employed full-time. BMC Psychiatry. 2013 Dec 1;13:324. http://dx.doi.org/10.1186/1471-244X-13-324

Fuertes JN, Mislowack A, Bennett J, Paul L, Gilbert TC, Fontan G, Boylan LS. The physician-patient working alliance. Patient Educ Couns. 2007 Apr;66(1):29-36. http://dx.doi.org/10.1016/j.pec.2006.09.013

DOI: http://dx.doi.org/10.15448/1980-6108.2015.2.21105

This journal is a member of COPE (Committee on Publication Ethics) and follow the principles recommended by this international reference organization on integrity and ethics in scientific publication.

Licença Creative Commons
Except where otherwise noted, the material published in this journal is licensed under a Creative Commons Attribution 4.0 International licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original publication is properly cited.
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

 Member of OASPA

Copyright: © 2006-2019 EDIPUCRS