Psychosocial Factors Associated with Patient Activation among Men Who Have Sex with Men Living with HIV in China: A Cross-Sectional Study

Background With the widespread use of antiretroviral therapy (ART), HIV infection has gradually become a chronic condition requiring long-term management. Patient activation plays an important role in promoting effective self-management and improving health outcomes among people living with HIV. However, limited evidence exists regarding patient activation and its psychosocial determinants among men who have sex with men (MSM) living with HIV in China. This study aimed to investigate the level of patient activation and explore its associated psychosocial factors in this population. Methods A cross-sectional study was conducted using convenience sampling. A total of 303 MSM living with HIV attending the Department of Infectious Diseases at the Second Hospital of Nanjing between December 2025 and February 2026 were recruited. Data were collected using a General Information Questionnaire, the Patient Activation Measure-13, the Berger HIV stigma scale-12, the Connor–Davidson Resilience Scale, and the Social Support Rating Scale. Pearson correlation analysis, univariate analysis, and multiple linear regression analysis were performed to identify factors associated with patient activation. Results The mean patient activation score among MSM living with HIV was 55.68 ± 9.62. Pearson correlation analysis showed that patient activation was negatively correlated with perceived discrimination ( r  = − 0.553, P  < 0.01) and positively correlated with psychological resilience ( r  = 0.495, P  < 0.01) and social support ( r  = 0.544, P  < 0.01). Multiple linear regression analysis indicated that duration since HIV diagnosis, number of comorbidities, disclosure of HIV status to others, perceived discrimination, psychological resilience, and social support were significant predictors of patient activation (all P  < 0.05), explaining 55.3% of the total variance. Conclusion Patient activation among MSM living with HIV is influenced by multiple psychosocial factors. Interventions aimed at reducing perceived discrimination and enhancing psychological resilience and social support may help improve patient activation and promote effective self-management among MSM living with HIV.