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The Information–Motivation–Behavioral Skills Model of ART Adherence in a Deep South HIV+ Clinic Sample

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Abstract

High levels of adherence to antiretroviral therapy (ART) are critical to the management of HIV, yet many people living with HIV do not achieve these levels. There is a substantial body of literature regarding correlates of adherence to ART, and theory-based multivariate models of ART adherence are emerging. The current study assessed the determinants of adherence behavior postulated by the Information–Motivation–Behavioral Skills model of ART adherence in a sample of 149 HIV-positive patients in Mississippi. Structural equation modeling indicated that ART-related information correlated with personal and social motivation, and the two sub-areas of motivation were not intercorrelated. In this Deep South sample, being better informed, socially supported, and perceiving fewer negative consequences of adherence were independently related to stronger behavioral skills for taking medications, which in turn associated with self-reported adherence. The IMB model of ART adherence appeared to well characterize the complexities of adherence for this sample.

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References

  • Amico, K. R., Toro-Alfonso, J., & Fisher, J. D. (2005). An empirical test of the information, motivation, behavioral skills model of antiretroviral therapy adherence. AIDS Care, 17(6), 661–673.

    Article  PubMed  CAS  Google Scholar 

  • Arnsten, J. H., Demas, P. A., Farzadegan, H., Grant, R. W., Gourevitch, M. N., Chang, C. J., et al. (2001). Antiretroviral therapy adherence and viral suppression in HIV-infected drug users: Comparison of self-report and electronic monitoring. Clinical Infectious Diseases, 33, 1417–1423.

    Article  PubMed  CAS  Google Scholar 

  • Bangsberg, D. R., Acosta, E. P., Gupta, R., Guzman, D., Riley, E. D., Harrogan, P. R., Parkin, N., & Deeks, S. G. (2006). Adherence-resistance relationships for protease and non-nucleoside reverse transcriptase inhibitors explained by virological fitness. AIDS, 20(2), 223–231.

    Article  PubMed  CAS  Google Scholar 

  • Bangsberg, D. R., & Deeks, S. G. (2002). Is average adherence to HIV antiretroviral therapy enough? Journal of General Internal Medicine, 17(10), 812–813.

    Article  PubMed  Google Scholar 

  • Bartlett, J. A. (2002). Addressing the challenges of adherence. Journal of Acquired Immune Deficiency Syndromes, 29, s2–s10.

    PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2004). HIV/AIDS Surveillance Report, 2004, vol. 16. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention. Retrieved June 1, 2006, from http://www.cdc.gov/hiv/stats/hasrlink.htm

  • Chesney, M. A., Ickovics, J. R., Chambers, D. B., Gifford, A. L., Neidig, J., Zwickl, B., et al. (2000). Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: The ACTG Adherence Instruments. AIDS Care, 12, 255–266.

    Article  PubMed  CAS  Google Scholar 

  • Copello, G. (2004). Congressional public policy forum: Fighting HIV/AIDS in the Southern United States. Retrieved November 7, 2006, from http://www.theaidsinstitute.org/downloads/fightaidsouth.doc

  • De Bruin, M., Hospers, H. J., Van Den Borne, H. W., Kok, G., & Prins, J. M. (2005). Theory- and evidence-based intervention to improve adherence to antiretroviral therapy among HIV-infected patients in the Netherlands: A pilot study. AIDS Patient Care and STDs, 19, 284–294.

    Article  Google Scholar 

  • Fisher, J. D., & Fisher, W. A. (1992). Changing AIDS risk behavior. Psychological Bulletin, 111, 455–474.

    Article  PubMed  CAS  Google Scholar 

  • Fisher, W. A., & Fisher, J. D. (1993). A general psychological model for changing AIDS risk behavior. In J. Pryor & G. Reeder (Eds.), The social psychology of HIV infection (pp. 127–153). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Fisher, J. D., & Fisher, W. A. (2000). Theoretical approaches to individual-level change. In J. Peterson & R. DiClemente (Eds.), HIV prevention handbook (pp. 3–55). New York: Kluwer Academic/Plenum Press.

    Google Scholar 

  • Fisher, W. A., Fisher, J. D., & Harman, J. (2003). The Information–Motivation–Behavioral skills model as a general model of health behavior change: Theoretical approaches to individual-level change. In J. Suls & K. Wallston (Eds.), Social psychological foundations of health (pp. 127–153). London: Blackwell Publishers.

    Google Scholar 

  • Fisher, J. D., Fisher, W. A., Amico, K. R., & Harman, J. J. (2006). An information–motivation–behavioral skills model of adherence to antiretroviral therapy. Health Psychology, 25, 462–473.

    Article  PubMed  Google Scholar 

  • Haubrich, R. H., Little, S. J., Currier, J. S., Forthal, D. N., Kemper, C. A., Beall, G. N., et al. (1999). The value of patient-reported adherence to antiretroviral therapy in predicting virologic and immunologic response. AIDS, 13, 1099–1107.

    Article  PubMed  CAS  Google Scholar 

  • Kalichman, S. C., Rompa, D., DiFonzo, K., Simpson, D., Austin, J., Luke, W., Kyomugisha, F., & Buckles, J. (2001). HIV treatment adherence in women living with HIV/AIDS: Research based on the Information–Motivation–Behavioral Skills model of health behavior. Journal of the Association of Nurses in AIDS Care, 12(4), 58–67.

    Article  PubMed  CAS  Google Scholar 

  • Kleeberger, C. A., Phair, J. P., Strathdee, S. A., Detels, R., Kingsley, L., & Jacobson, L. P. (2001). Determinants of heterogeneous adherence to HIV-antiretroviral therapies in the Miluticenter AIDS Cohort Study. Journal of Acquired Immune Deficiency Syndromes, 26(1), 82–92.

    PubMed  CAS  Google Scholar 

  • Kline, R. B. (2005). Principles and practice of structural equation modeling, 2nd ed. NY: Guilford.

    Google Scholar 

  • Knobel, H., Guelar, A., Carmona, A., Espona, M., Gonzalez, A., Lopez-Colimes, J. L., et al. (2001). Virologic outcome and predictors of virologic failure of highly active antiretroviral therapy containing protease inhibitors. AIDS Patient Care and STDs, 15(4), 193–199.

    Article  PubMed  CAS  Google Scholar 

  • Lichtenstein, B., Laska, M. K., & Clair, J. M. (2002). Chronic sorrow in the HIV-positive patient: Issues of race, gender, and social support. AIDS Patient Care and STDs, 16(1), 27–38.

    Article  PubMed  Google Scholar 

  • LifeWindows Project Team (2006). The LifeWindows Information Motivation Behavioral Skills ART Adherence Questionnaire (LW-IMB-AAQ). Retrieved December 20, 2006, from http://www.chip.uconn.edu/int/F_LWIMBARTQuestionnaire.pdf

  • Lucas, G. M. (2005). Antiretroviral adherence, drug resistance, viral fitness, and HIV disease progression: A triangle web is woven. Journal of Antimicrobial Chemotherapy, 55, 413–416.

    Article  PubMed  CAS  Google Scholar 

  • Moatti, J. P., & Spire, B. (2000). Living with HIV/AIDS and adherence to antiretroviral treatments. In J.-P. Moatti, Y. Souteyrand, A. Prieur, T. Sandfort, & P. Aggleton (Eds.), AIDS in Europe: New challenges for the social sciences (pp. 57–73). New York: Routledge.

    Google Scholar 

  • Murri, R., Ammassari, A., Gallicano, K., De Luca, A., Cingolani, A., Jacobson, D., et al. (2000). Patient-reported non-adherence to HAART is related to protease inhibitor levels. Journal of Acquired Immune Deficiency Syndrome, 24(2), 123–128.

    CAS  Google Scholar 

  • Nieuwkerk, P. T., & Oort, F. J. (2005). Self-reported adherence to antiretroviral therapy for HIV-1 infection and virologic treatment response: A meta-analysis. Journal of Acquired Immune Deficiency Syndromes, 38(4), 445–448.

    Article  PubMed  Google Scholar 

  • Nieuwkerk, P. T., Sprangers, M. A., Burger, D. M., Hoetelmans, R. M., Hugan, P. W., Danner, S. A., et al. (2001). Limited patient adherence to highly active antiretroviral therapy for HIV-1 infection in an observational cohort study. Archives of Internal Medicine, 161(16), 1962–1968.

    Article  PubMed  CAS  Google Scholar 

  • Paterson, D. L., Swindells, S., Mohr, J., Brester, M., Vergis, E. N., Aquier, C., Wagener, M. M., & Singh, N. (2000). Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annals of Internal Medicine, 133, 21–30.

    PubMed  CAS  Google Scholar 

  • Pearson, C. R., Simoni, J. M., Hoff, P., Kurth, A. E., & Martin, D. P. (2007). Assessing antiretroviral adherence via electronic drug monitoring and self-report: An examination of key methodological issues. AIDS and Behavior, 11(2), 161–173.

    Article  PubMed  Google Scholar 

  • Pfizer (2005). Global HIV/AIDS partnerships: Southern HIV/AIDS prevention initiative. Retrieved November 7, 2006, from http://www.pfizer.com/pfizer/subsites/philanthropy/caring/global.health.hiv.southern.jsp

  • Simoni, J. M., Frick, P. A., & Huang, B. (2006a). A longitudinal evaluation of a social support model of medication adherence among HIV-positive men and women on antiretroviral therapy. Health Psychology, 25, 74–81.

    Article  PubMed  Google Scholar 

  • Simoni, J. M., Kurth, A. E., Pearson, C. R., Pantaline, D. W., Merrill, J. O., & Frick, P. A. (2006b). Self-report measures of antiretroviral therapy adherence: A review with recommendations for HIV research and clinical management. AIDS and Behavior, 10(3), 227–245.

    Article  PubMed  Google Scholar 

  • Starace, F., Massa, A., Amico, R., & Fisher, J. D. (2006). Adherence to antiretroviral therapy: An empirical test of the information–motivation–behavioral skills model. Health Psychology, 25(2), 153–162.

    Article  PubMed  Google Scholar 

  • Wagner, G., & Miller, L. G. (2004). Is the influence of social desirability on patients’ self-reported adherence overrated? Journal of Acquired Immune Deficiency Syndromes, 35(2), 203–204.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Special thanks to Jo Ann Lewis for her assistance with data collection, and to the staff and patients at the Adult Special Care Clinic at the University of Mississippi Medical Center. This research was funded by the following research grants: R01- MH066684 and NINR K23 NR09186. Funding: R01-MH066684 to Jeffrey D. Fisher. NINR K23 NR09186 to Deborah J. Konkle-Parker.

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Authors and Affiliations

  1. Center for Health, Intervention, and Prevention, University of Connecticut, 2006 Hillside Rd., Unit 1248, Storrs, CT, 06269-1248, USA

    K. Rivet Amico, William Barta, Jeffrey D. Fisher, Deborah H. Cornman, Paul A. Shuper & William A. Fisher

  2. University of Mississippi Medical Center, Jackson, MS, USA

    Deborah J. Konkle-Parker

  3. Department of Psychology, University of Western Ontario, London, ON, Canada

    William A. Fisher

  4. Department of Obstetrics and Gynecology, University of Western Ontario, London, ON, Canada

    William A. Fisher

Authors
  1. K. Rivet Amico
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  2. William Barta
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  3. Deborah J. Konkle-Parker
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  4. Jeffrey D. Fisher
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  5. Deborah H. Cornman
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  6. Paul A. Shuper
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  7. William A. Fisher
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Correspondence to K. Rivet Amico.

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Amico, K.R., Barta, W., Konkle-Parker, D.J. et al. The Information–Motivation–Behavioral Skills Model of ART Adherence in a Deep South HIV+ Clinic Sample. AIDS Behav 13, 66–75 (2009). https://doi.org/10.1007/s10461-007-9311-y

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  • DOI: https://doi.org/10.1007/s10461-007-9311-y

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