The Relationship Between Self-Efficacy and Antiretroviral Medication Adherence Among People Living with HIV: A Cross-Sectional Study at CAKAP WPA Turen Foundation

Tri Nurhudi Sasono; Nia Agustiningsih; Galuh Kumalasari; Lintang Puspita Prabarini; Ainun Hurrotaini; Lailatul Kodriyah; Ella Mayasari; Zahrah Saad

doi:10.58545/jrcnp.v4i2.1008

Authors

Tri Nurhudi Sasono Nursing Study Program, Universitas Kepanjen, Malang, Indonesia https://orcid.org/0000-0003-4635-7147
Nia Agustiningsih Nursing Study Program, Universitas Kepanjen, Malang, Indonesia https://orcid.org/0000-0002-0003-3078
Galuh Kumalasari Nursing Study Program, Universitas Kepanjen, Malang, Indonesia
Lintang Puspita Prabarini Nursing Study Program, Universitas Kepanjen, Malang, Indonesia https://orcid.org/0000-0003-2224-4762
Ainun Hurrotaini Nursing Study Program, Universitas Kepanjen, Malang, Indonesia https://orcid.org/0009-0001-8444-894X
Lailatul Kodriyah Hospital Administration Study Program, Universitas Kepanjen, Malang, Indonesia https://orcid.org/0000-0001-8961-1913
Ella Mayasari Hospital Administration Study Program, Universitas Kepanjen, Malang, Indonesia https://orcid.org/0000-0002-6111-2853
Zahrah Saad Faculty of Nursing and Midwifery, Mahsa University, Malaysia

DOI:

https://doi.org/10.58545/jrcnp.v4i2.1008

Abstract

Background: Antiretroviral (ARV) therapy is essential for people living with HIV(PLHIV) to control viral replication and maintain long-term health. However, maintaining adherence to ARV therapy remains a challenge. Self-efficacy, defined as an individual's confidence in their ability to perform health-related behaviors, may play an important role in maintaining consistent adherence to ARV medication. Purpose: This study aimed to determine the relationship between self-efficacy and adherence to ARV medication among people living with HIV at Yayasan Cahaya Kasih Peduli WPA Turen, Malang Regency, Indonesia. Methods: This study used a quantitative descriptive-analytic design with a cross-sectional approach. The study involved 70 PLHIV selected using purposive sampling. Data were collected using a self-efficacy questionnaire and an ARV medication adherence questionnaire. Self-efficacy was categorized as high or low based on the instrument's predetermined cut-off score, while ARV adherence was categorized as adherent or non-adherent based on the adherence instrument's predetermined cut-off score. Data were analyzed using univariate and bivariate analyses, with statistical significance set at p≤0.05. Results: Of the 70 respondents, 48 (68.6%) had high self-efficacy and 22 (31.4%) had low self-efficacy. A total of 52 respondents (74.3%) were adherent to ARV therapy, while 18 (25.7%) were non-adherent. Among respondents with high self-efficacy, 42 (87.5%) were adherent and 6 (12.5%) were non-adherent, compared with 10 (45.5%) adherent and 12 (54.5%) non-adherent among those with low self-efficacy. Statistical analysis demonstrated a significant relationship between self-efficacy and ARV adherence (p=0.001). Respondents with high self-efficacy had seven times greater odds of adhering to ARV therapy than those with low self-efficacy (OR=7.00; 95% CI=2.20–22.28). Conclusions: Self-efficacy was significantly associated with ARV medication adherence among PLHIV at Yayasan Cahaya Kasih Peduli WPA Turen. Strengthening self-efficacy through continuous counseling, education, peer support, and community-based assistance may support sustained adherence to ARV therapy. Further longitudinal and intervention studies are recommended to determine the effectiveness of self-efficacy-based approaches in improving long-term ARV adherence.

Keywords:

Self-efficacy, Antiretroviral therapy, Medication adherence, People living with HIV, HIV/AIDS

Downloads

Download data is not yet available.

References

Abdelgawad, M. (2026). The impact of health literacy on diabetic patients’ quality of life through self-management, self-care behaviours and glycaemic control in Eastern Mediterranean Region: A systematic review. Public Health Institute Journal. 6. https://openjournals.ljmu.ac.uk/PHIJ/article/view/2388

Ashaba, Baguma, C., Tushemereirwe, P., Nansera, D., Maling, S., Zanon, B. C., & Id, A. C. T. (2024). PLOS GLOBAL PUBLIC HEALTH Correlates of HIV treatment adherence self- efficacy among adolescents and young adults living with HIV in southwestern Uganda. 1–10. https://doi.org/10.1371/journal.pgph.0003600

Asmara, Y. V., Nurhayatun, E., & Putri, D. P. (2025). Duration vs Discipline : Uncovering Therapy Adherence Antiretrovirals in People with HIV. 10, 65–72. https://doi.org/10.26911/theijmed.2025.10.1.803

Ayieko, P., Willkens, M., Issarow, B., Deogratias, D., Fitzgerald, D. W., Grosskurth, H., Kisigo, G., Okello, E., Metsch, L. R., Peck, R. N., Kapiga, S., & Lee, M. H. (2026). Self-Efficacy and One-Year HIV Outcomes for Hospitalized People with HIV in Tanzania: A Mediation Analysis of the Daraja Clinical Trial. AIDS and Behavior, 30(4), 1022–1029. https://doi.org/10.1007/s10461-025-04917-2

Bwire, G. M., Njiro, B. J., Ndumwa, H. P., Munishi, C. G., Mpondo, B. C., Mganga, M., Mang’ombe, E., Bakari, M., Sangeda, R. Z., Sudfeld, C. R., & Killewo, J. (2023). Impact of differentiated service delivery models on retention in HIV care and viral suppression among people living with HIV in sub-Saharan Africa: A systematic review and meta-analysis of randomised controlled trials. Reviews in Medical Virology, 33(6), e2479. https://doi.org/10.1002/rmv.2479

Fauk, N. K., Gesesew, H. A., Seran, A. L., Raymond, C., Tahir, R., & Ward, P. R. (2022). Barriers to Accessing HIV Care Services in Host Low and Middle Income Countries: Views and Experiences of Indonesian Male Ex-Migrant Workers Living with HIV. International Journal of Environmental Research and Public Health, 19(21). https://doi.org/10.3390/ijerph192114377

Fauk, N. K., Gesesew, H. A., Seran, A. L., & Ward, P. R. (2023). Barriers to access to antiretroviral therapy by people living with HIV in an indonesian remote district during the COVID-19 pandemic: a qualitative study. BMC infectious diseases, 23(1), 296. https://doi.org/10.1186/s12879-023-08221-z

Fauk, N. K., Hawke, K., Mwanri, L., & Ward, P. R. (2021). Stigma and Discrimination towards People Living with HIV in the Context of Families, Communities, and Healthcare Settings: A Qualitative Study in Indonesia. International Journal of Environmental Research and Public Health, 18(10). https://doi.org/10.3390/ijerph18105424

Hosseini, Z., & Rad, R. E. (2024). Relationship between self ‐ efficacy and adherence to antiretroviral therapy in HIV / AIDS patients : An analytical cross ‐ sectional study in southern Iran. December 2023, 1–9. https://doi.org/10.1002/hsr2.1879

Hutahaean, B. S. H., Stutterheim, S. E., & Jonas, K. J. (2023). Barriers and Facilitators to HIV Treatment Adherence in Indonesia: Perspectives of People Living with HIV and HIV Service Providers. Tropical medicine and infectious disease, 8(3), 138. https://doi.org/10.3390/tropicalmed8030138

Ibrahim, K., Herliani, Y. K., Rahayuwati, L., Khadijah, S., & Sutini, T. (2022). Healthcare needs of people living with human immunodeficiency virus: A qualitative descriptive study. Nursing Open, 9(1), 349–357. https://doi.org/https://doi.org/10.1002/nop2.1071

Iryawan, A. R., Stoicescu, C., Sjahrial, F., Nio, K., & Dominich, A. (2022). The impact of peer support on testing , linkage to and engagement in HIV care for people who inject drugs in Indonesia : qualitative perspectives from a community ‑ led study. Harm Reduction Journal, 1–13. https://doi.org/10.1186/s12954-022-00595-8

Isabirye, R., Opii, D. J., Opio Ekit, S., Kawomera, A., Lokiru, L., Isoke, R., Ssenkaali, J., & Puleh, S. S. (2023). Factors Influencing ART Adherence Among Persons Living with HIV Enrolled in Community Client-Led Art Delivery Groups in Lira District, Uganda: A Qualitative Study. HIV/AIDS (Auckland, N.Z.), 15, 339–347. https://doi.org/10.2147/HIV.S414971

Liu, C., Yaremenko, A. V, Li, X., You, X., Zhu, X., Liu, N., Chen, W., Kong, N., Xie, T., Gaiha, G. D., Langer, R., & Tao, W. (2026). mRNA technology for the prevention and treatment of HIV-1 infection. Nature Reviews Bioengineering, 4(5), 435–453. https://doi.org/10.1038/s44222-025-00387-2

Øgård-Repål, A., Berg, R. C., Skogen, V., & Fossum, M. (2022). Peer support in an outpatient clinic for people living with human immunodeficiency virus: a qualitative study of service users’ experiences. BMC Health Services Research, 22(1), 549. https://doi.org/10.1186/s12913-022-07958-8

Saenjun, P., Vongsirimas, N., & Klainin-Yobas, P. (2025). Factors influencing antiretroviral therapy adherence among youth living with HIV: a systematic review and meta-analysis. BMC public health, 25(1), 4213. https://doi.org/10.1186/s12889-025-25357-6

Supriyatni, N., Agus Salim, L., Hargono, A., Sumiati, T., Lestari, T., & Andiani. (2025). Correlation of Self-Efficacy, Action Planning, and Coping Planning to ARV Adherence in HIV Patients in Ternate, Indonesia. Jurnal Kesehatan, 18(3), 375–386. https://doi.org/10.23917/jk.v18i3.12648

Sasono, T. N. ., & Hurrotaini, A. (2026). Impact of Household Food Security and Government Food Assistance on the Nutritional Status of PLHIV in Malang, Indonesia. Journal of Health and Nutrition Research, 5(2), 662–672. https://doi.org/10.56303/jhnresearch.v5i2.1150

WHO. (2021). Updated recommendations on service delivery for the treatment and care of people living with HIV. https://www.who.int/publications/i/item/9789240023581?utm_source=chatgpt.com

Yona, S., Edison, C., Nursasi, A. Y., & Ismail, R. (2023). Self-awareness as the key to successful adherence to antiretroviral therapy among people living with HIV in Indonesia: A grounded theory study. Belitung Nursing Journal, 9(2), 176–183. https://doi.org/10.33546/bnj.2480

Zahra, A. N., Waluyo, A., Yona, S., & Pakasi, T. A. (2024). Resilience in Relation to Adherence to Antiretroviral Therapy in People Living With HIV: A Qualitative Study. Global Qualitative Nursing Research, 11, 23333936241233450. https://doi.org/10.1177/23333936241233449