Medication literacy and treatment adherence in people living with human immunodeficiency virus: Mediating effects of psychosocial factors

Table 4 Mechanisms through which social support networks influence treatment adherence in people living with human immunodeficiency virus

Type of support	Mechanism of action	Key research findings	Implications for intervention	Ref.
Peer support	Buffers HIV-related stigma through emotional and informational support	Strongly associated with long-term retention, adherence, and viral suppression among people living with HIV; reduces internalized stigma	Develop peer-based support networks, especially virtual support communities	[47,50,51]
Family support	Serves as a buffering variable between literacy and adherence, providing emotional and practical aid	Mitigates the negative effects of low medication literacy on adherence; improves adherence through medication reminders and accompaniment to care	Involve family members in medication supervision, especially for children and adolescents	[53]
Patient–provider trust	Promotes adherence by reducing patients’ suspicion and fear toward the healthcare system	Lower trust is linked to poorer adherence and treatment outcomes; particularly affects racial and ethnic minority groups	Enhance provider communication skills and adopt culturally adaptive strategies	[56]
Community support networks	Mitigate the negative effects of spatial exclusion by creating alternative healthcare pathways	Community health workers play a key role in sustaining access to antiretroviral therapy; stigma at the community level shapes care-seeking geography	Implement task-sharing interventions with lay providers; build destigmatized support networks	[87]

HIV: Human immunodeficiency virus.