The importance of antiretroviral therapy adherence for patients living with HIV/AIDS has been well documented. Despite this critical need, many do not follow prescribed regimens. To examine the barriers that lead to non-adherence, we used cross-sectional survey data from a randomized controlled intervention trial in northern and north-eastern Thailand. Of the 507 patients that were enrolled in the trial, we analyzed 386 patients on antiretroviral therapy in order to examine the barriers to adherence. In addition to demographic characteristics, depressive symptoms, physical health, access to care, social support, and internalized shame, HIV disclosure and family communication were examined. The correlation analysis revealed that adherence is significantly associated with internalized shame, access to care, depressive symptoms, and family communication. Based on the multiple logistic regression analysis, depressive symptoms, access to care, HIV disclosure, and family communication were significant predictors of adherence. Having depressive symptoms remains a significant barrier to adherence, while access to care, HIV disclosure, and family communication play important positive roles. Our findings underscore the critical importance of addressing these various challenges that can influence adherence to antiretroviral therapy.

Despite government efforts to increase health care insurance and access in China, many individuals, regardless of insurance status, continue to engage in high levels of self-medication. To understand the factors influencing common self-medication behaviour in a community of food market venders in Fuzhou China, a total of 30 market venders were randomly recruited from six food markets in 2007. In-depth interviews were conducted with each participant at their market stalls by trained interviewers using a semi-structured open-ended interview protocol. Participants were asked broad questions about their health-seeking behaviours as well as their past experiences with self-medication and hospital care. ATLAS.ti was used to manage and analyze the interview data. The results showed that hospital-based health care services were perceived as better quality. However, self-medication was viewed as more affordable in terms of money and time. Other factors prompting self-medication included confidence in understanding the health problem, the easy accessibility of local pharmacies, and the influences of friends/peers and advertising. Three broad domains, attitude, cost, and effectiveness, were all seen to determine past decisions and experiences with self-medication. Interestingly, the effective management of self-medication via pharmacy resources raised particular concern because of perceived variation in quality. In conclusion, self-medication was found to be an important and common health-seeking behaviour driven by multiple factors. A sound and comprehensive public health system should systematically attend to these behaviours and the pharmacies where much of the behaviour occurs.

Background The study examined concurrent illicit heroin use among methadone maintenance clients in China and its association with clients’ demographic characteristics, treatment experience, and personal social network. Methods Face-to-face surveys were conducted with 178 clients randomly recruited from six methadone maintenance treatment (MMT) clinics in Sichuan, China. Concurrent heroin use was measured based on self-report of heroin use during the past 30 days and a confirmatory urine morphine test. The participants’ demographic characteristics and treatment factors were measured and examined. The drug use status of their family members and friends was also assessed. Results A total of 80 participants (44.9%) who either reported illicit heroin use in the past 30 days or had a positive urine test were defined as using heroin concurrently. Having drug-using friends was significantly associated with increased concurrent heroin use. Longer length of treatment (2 years or longer) was associated with increased concurrent heroin use. Among those who had both drug-using family members and friends, more women (71.4%) than men (50.0%) used heroin. For those who had no drug-using family members or friends, more men (34.8%) than women (20.8%) used heroin. Discussion Study findings indicate an urgent need to address concurrent illicit heroin use among MMT clients. Further examination of the influence of social networks on concurrent drug abuse behavior is encouraged. Results also highlight the importance of understanding gender differences in treatment seeking and behavioral changes, which is crucial to the development of gender-specific treatment strategies.

Rural residents benefit greatly from the implementation of NRCMIS. Future reform could be more effective by catering the needs of each specific group (e.g. low-income population, rural population, etc.) identified by this study.

This study aims to investigate health care providers’ empathy levels and its association with avoidance in providing service to patients living with HIV/AIDS (PLWHA) in China. A total of 1760 health service providers were randomly sampled from 40 county hospitals in two provinces of China. Using a self-administered questionnaire, participants’ demographic characteristics, work history, empathy level, and avoidance attitudes toward PLWHA were collected in a cross-sectional survey. Empathy was higher among participants aged 31–40 years, those who had an associated medical degree, and those who had served in the medical profession for less than 20 years. Nurses, younger providers, and providers with lower education tended to avoid contact with PLWHA. Multiple linear regression model showed that a higher level of empathic attitude toward patients was significantly negatively associated with avoidance attitude toward PLWHA. Service providers’ empathy level plays an important role in providing quality care to HIV-infected patients. Future stigma reduction interventions should cultivate empathy as a platform for understanding, effective communication, and trusting provider–patient relationships. PLWHA could potentially benefit from attitudinal change in medical settings.