Unmasking the Barriers to HIV Treatment Continuity in China

Antiretroviral therapy (ART) has transformed HIV from a fatal diagnosis into a manageable chronic condition, but its success depends entirely on consistent adherence. A new meta-analysis reviewing 19 studies up to January 2025 provides a systematic evaluation of treatment attrition—essentially, the rate at which patients drop out of care—among people living with HIV in China.

The researchers calculated an attrition rate of 4.0 per 100 person-years. To visualise this metric, imagine following 100 patients for a year; statistically, four would cease their medication. The study uncovered a complex web of influencing factors. Demographically, being male, older, or living alone significantly increased the likelihood of stopping treatment. Clinical variables were also critical: patients experiencing adverse drug reactions or those on regimens including protease inhibitors were more prone to attrition.

Social determinants proved equally powerful. Inconvenient access to medication and low family support were strongly associated with higher dropout rates. The findings suggest that reducing attrition requires more than just prescribing pills; it demands optimised logistical access, rapid treatment initiation after diagnosis, and robust social support networks.