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<p>Antiretroviral Therapy (ART) adherence is a complex outcome influenced by individual, interpersonal, and structural factors. Social support can improve adherence, yet studies report inconsistent associations between social support and ART adherence, potentially resulting from differences in operationalization and measurement. We conducted a scoping review of articles published between 2014 and 2024 using Arksey and O’Malley’s framework to (a) identify how social support and adherence are operationalized and measured, (b) explore relationships between social support and ART adherence, and (c) compare associations across different measures. We identified 118 articles; 87 (74%) reported positive associations between social support and adherence, 28 (24%) found no association, and three reported negative associations. Associations varied by support source (children, spouses, family members, and healthcare providers), type (instrumental, emotional, informational), and nature (same-gender ties). Four ART measures were identified: self-report, indirect measures, biological markers, and composite measures. Most studies (109) assessed perceived or functional social support, while only six examined structural support and network relationships (e.g., the respondent and their partners). Significant variations existed in adherence measures and benchmarks. Social support measures also varied substantially, with limited theoretical justification for selection. Mixed findings reflect measurement variations and the multifaceted nature of social support. Future studies should investigate both constructs comprehensively and systematically, using composite measures with objective biomarkers where feasible, and accounting for measurement differences and literature gaps.</p>

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A Scoping Review Assessing the Relationship Between Structural, Functional, and Perceived Social Support with Antiretroviral Therapy (ART) in the Last Decade

  • 期刊论文

  • 发表日期：

    2026年4月3日

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  • Anubhuti Poudyal,
  • Ada Thapa,
  • Kathleen J. Sikkema

摘要

Antiretroviral Therapy (ART) adherence is a complex outcome influenced by individual, interpersonal, and structural factors. Social support can improve adherence, yet studies report inconsistent associations between social support and ART adherence, potentially resulting from differences in operationalization and measurement. We conducted a scoping review of articles published between 2014 and 2024 using Arksey and O’Malley’s framework to (a) identify how social support and adherence are operationalized and measured, (b) explore relationships between social support and ART adherence, and (c) compare associations across different measures. We identified 118 articles; 87 (74%) reported positive associations between social support and adherence, 28 (24%) found no association, and three reported negative associations. Associations varied by support source (children, spouses, family members, and healthcare providers), type (instrumental, emotional, informational), and nature (same-gender ties). Four ART measures were identified: self-report, indirect measures, biological markers, and composite measures. Most studies (109) assessed perceived or functional social support, while only six examined structural support and network relationships (e.g., the respondent and their partners). Significant variations existed in adherence measures and benchmarks. Social support measures also varied substantially, with limited theoretical justification for selection. Mixed findings reflect measurement variations and the multifaceted nature of social support. Future studies should investigate both constructs comprehensively and systematically, using composite measures with objective biomarkers where feasible, and accounting for measurement differences and literature gaps.