HIV self-management and associated factors among people living with HIV in Hunan, China: a nine-year longitudinal study

Self-management refers to the behaviors and strategies individuals employ to manage their health conditions. For people living with HIV (PLWH), it encompasses medication adherence, health monitoring, symptom management, lifestyle maintenance and seeking emotional support. While previous studies on the factors influencing self-management in PLWH are predominantly cross-sectional, longitudinal studies are scarce. This nine-year longitudinal study aimed to investigate the trajectories of psychosocial characteristics in PLWH and their effects on self-management. A total of 265 PLWH were assessed for psychosocial factors, including stigma, depression, anxiety, and social support, at baseline and at one-, five- and nine-year follow-ups. Self-management was evaluated at the nine-year follow-up. Psychosocial trajectories were identified using latent growth trajectory models (LGMM), and associations with self-management were analyzed via multiple linear regression. The majority of participants exhibited a low-level decline in depression (79.6%) and rising social support (54.3%). The high-level decline depression group demonstrated the lowest self-management scores (b = -4.67, 95% CI: -8.166 to -1.175). Multivariate analysis revealed significant associations between self-management and exercise (b = 5.360, 95% CI: 3.934-6.786), depressive symptoms (b = -0.168, 95% CI: -0.305 to -0.031) and social support (b = 0.182, 95% CI: 0.101-0.264). These findings emphasize the need for continuous monitoring and targeted interventions to improve self-management in PLWH.