The impact of perceived stress on self-management behaviors among men who have sex with men living with HIV in China: the mediating role of self-regulatory fatigue

BACKGROUND: As a chronic disease, effective HIV self-management is crucial for men who have sex with men (MSM) living with HIV. Psychosocial factors, including perceived stress and self-regulatory fatigue, have been shown to negatively impact self-management behaviors. However, research on the relationships among perceived stress, self-regulatory fatigue, and self-management behaviors remains limited. This study aimed to explore the mediating effect of self-regulatory fatigue in the relationship between perceived stress and self-management behaviors among MSM living with HIV in China. METHODS: From December 2024 to March 2025, cross-sectional data were collected from 328 MSM living with HIV at an HIV-designated hospital in Jiangsu Province using convenience sampling. Data were collected using the Perceived Stress Scale, Self-Regulatory Fatigue Scale, and HIV Self-Management Scale. Descriptive statistics, univariate analysis, and Pearson correlation analysis were performed in this study. The mediating effect of self-regulatory fatigue in the relationship between perceived stress and self-management behaviors was assessed using Model 4 of the PROCESS macro for SPSS. RESULTS: Among 328 MSM living with HIV, the average score of perceived stress was 30.67 ± 7.87, the average self-regulatory fatigue score was 43.99 ± 8.76, and the average HIV self-management score was 36.65 ± 7.88. Perceived stress was positively related to self-regulatory fatigue (r = 0.544, p