Evidence map›Paper›PMID 41571948›Full record

ArticleAIDS and behavior2026

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

Joseph Awad, Wenxiu Sun, Diane Santa Maria, Rebecca Schnall, Panta Apiruknapanond, Tongyao Wang, Claudia Patricia Valencia, Christine Horvat Davey, Solymar Solis Baez, Emilia Iwu and 8 more

Erratum issuedAbstract read
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In one paragraph

Article in AIDS and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors.

Joseph AwadDepartment of Psychology, University of California Los Angeles, Los Angeles, CA, USA. josephawad@ucla.edu.ORCID https://orcid.org/0009-0009-8758-518X
Wenxiu SunShanghai Public Health Clinical Center, Fudan University, Shanghai, 201500, CA, China.
Diane Santa MariaDepartment of Research, Cizik School of Nursing at UTHealth, 6901 Bertner Avenue, Houston, TX, 77030-3901, USA.ORCID http://orcid.org/0000-0001-8202-226X
Rebecca SchnallSchool of Nursing, Columbia University, 560 West 168, New York, NY, 10032, USA.ORCID https://orcid.org/0000-0003-2184-4045
Panta ApiruknapanondSaint Louis College of Nursing, 19 S Sathon Rd, Yan Nawam, Sathon, Bangkok, 10120, Thailand.
Tongyao WangSchool of Nursing, The University of Hong Kong, Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong, China.ORCID https://orcid.org/0000-0003-3374-1078
Claudia Patricia ValenciaSchool of Nursing, PROMESA Research Group, Universidad del Valle, Cali, Colombia.ORCID http://orcid.org/0000-0002-9558-4146
Christine Horvat DaveyFrances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106, USA.ORCID http://orcid.org/0000-0002-3686-4391
Solymar Solis BaezAuxilio Mutuo Hospital, PO Box 191227, San Juan, PR, 00919, USA.ORCID http://orcid.org/0000-0003-2563-6307
Emilia IwuCenter for Global Health, School of Nursing, Rutgers University, 180 University Ave, Newark, NJ, 07102, USA.ORCID https://orcid.org/0000-0003-0261-7218
Motshedisi Sabone, Gaborone, Botswana.ORCID https://orcid.org/0000-0001-5181-6534
Lufuno MakhadoDepartment of Public Health, University of Venda, University Road, Private Bag X5050, Thohoyandou, 0950, South Africa.
Yvette P CucaUCSF School of Nursing, 490 Illinois Street, Floor 9, San Francisco, CA, 94143, USA.ORCID https://orcid.org/0000-0002-5674-4741
J Craig PhillipsFaculty of Health Sciences, School of Nursing, University of Ottawa, 451 Smyth Road, RGGN 3249A, Ottawa, ON, K1S 8M5, Canada.ORCID https://orcid.org/0000-0002-6697-0515
Inge B CorlessMGH Institute of Health Professions School of Nursing, Boston, USA.ORCID https://orcid.org/0000-0003-0438-2037
Sheila ShaibuSchool of Nursing and Midwifery, 3, Aga Khan University, Parklands, Nairobi, Kenya.ORCID https://orcid.org/0000-0002-6300-4047
Carol Dawson-RoseUCSF School of Nursing, 490 Illinois Street, Floor 9, San Francisco, CA, 94143, USA.ORCID https://orcid.org/0000-0001-6066-1853
Wei-Ti ChenLulu Wolf Hassenplug Chair in Nursing, Joe C. Wen School of Nursing, University of California Los Angeles, Los Angeles, CA, USA. wchen@sonnet.ucla.edu.ORCID http://orcid.org/0000-0002-2342-045X

Funding

UCLA Rapid, Relevant, Rigorous Implementation Science HubP30MH058107 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Sung-Jae Lee · 1997 to 2026
$53.5M
CHAMPS: A randomized trial of a Community Health Worker intervention for persons living with HIV in two high priority settingsR01NR019758 · NINR · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI BATEY, DAVID S., SCHNALL, REBECCA · 2020 to 2023
$2.9M
Development and Pilot Testing of a Just in Time Mobile Smoking Cessation Intervention for Persons living with HIVR21CA265961 · NCI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI HUANG, MING-CHUN, SCHNALL, REBECCA · 2021 to 2022
$439k
Relationship of Formal Exercise Interventions, Sleep, and Inflammation Markers in People Living with HIVK23NR019744 · NINR · CASE WESTERN RESERVE UNIVERSITY · PI HORVAT DAVEY, CHRISTINE · 2021 to 2023
$393k
AHRQ HHS R18 HS028523AHRQ HHS R18HS028523NCI NIH HHS R21 CA265961NCI NIH HHS R21CA265961NIMH NIH HHS P30 MH058107NIMH NIH HHS P30MH058107NINR NIH HHS K23 NR019744NINR NIH HHS K23NR019744NINR NIH HHS R01 NR019758NINR NIH HHS R01NR019758Shanghai Municipal Health Commission 2021QN-B01
6 · The paper itself

Abstract

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 N = 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.

Indexed as

ART adherenceMental healthPLHIVSocial supportSubstance use

Identifiers

PMID41571948

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.