The Information-Motivation-Behavioral Skills model of antiretroviral adherence and its applications
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Abstract
Suboptimal adherence to highly active antiretroviral therapy (HAART) may have serious consequences for HIV patients, and for public health overall. The Information-Motivation-Behavioral Skills (IMB) model of HAART adherence can be used to understand the dynamics of HAART adherence and to intervene with patients to promote more optimal levels of adherence. This article reviews the core hypotheses of the IMB model of HAART adherence and describes available correlational and experimental evaluations of the model, outcomes of adherence intervention trials that applied the model, and IMB model-based interventions that are currently under evaluation. It then explores one potential promising application of the model that uses a protocol originally developed and demonstrated as a structured patient-centered, provider-delivered risk reduction intervention to deliver information, motivation, and behavioral skills-based adherence-promotion strategies. This protocol could be incorporated into clinical practice as a valuable tool in working with patients individually.
Keywords
Behavioral Skill Adherence Behavior Amico Suboptimal Adherence Adherence InformationReferences and Recommended Reading
- 1.US Department of Health and Human Services: Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents. Atlanta: Centers for Disease Control and Prevention; 2002.Google Scholar
- 2.Joint United Nations Programme on HIV/AIDS: 2006 Report on the global AIDS epidemic: executive summary. Available at http://www.unaids.org/en/HIV_data/2006GlobalReport/default.asp. Accessed June 4, 2006.
- 3.Jensen-Fangel A, Pederson L, Pederson C, et al.: Low mortality in HIV-infected patients starting highly active antiretroviral therapy: a comparison with the general population. AIDS 2004, 18:89–97.PubMedCrossRefGoogle Scholar
- 4.Palella FJ, Deloria-Knoll M, Chimiel JS, et al.: Survival benefit of initiating antiretroviral therapy in HIV-infected persons in different CD4+ cell strata. Ann Intern Med 2003, 138:620–626.PubMedGoogle Scholar
- 5.Pradier C, Carrieri P, Bentz L, et al.: Impact of short-term adherence on virological and immunological success of HAART: a case study among French HIV-infected IDUs. Int J STD AIDS 2001, 12:324–328.PubMedCrossRefGoogle Scholar
- 6.Roca B, Gomez CJ, Arnedo A: Adherence, side effects, and efficacy of stavudine plus lamivudine plus nelfinavir in treatment-experienced HIV-infected patients. J Infect 2000, 41:50–54.PubMedCrossRefGoogle Scholar
- 7.Shor-Posner G, Lecusay R, Miguez-Burbano MJ, et al.: Quality of life measures in the Miami HIV-1 infected drug abusers cohort: relationship to gender and disease status. J Subst Abuse 2000, 11:395–404.PubMedCrossRefGoogle Scholar
- 8.Turpin JA: The next generation of HIV/AIDS drugs: novel and developmental anti-HIV drugs and targets. Expert Rev Anti Infect Ther 2003, 1:97–128.PubMedCrossRefGoogle Scholar
- 9.Altice FL, Friedland GH: The era of adherence to HIV therapy. Ann Intern Med 1998, 129:503–504.PubMedGoogle Scholar
- 10.Bangsberg DR, Kroetz DL, Deeks SG: Adherence-resistance relationships to combination HIV antiretroviral therapy. Curr HIV/AIDS Rep 2007, 4:65–72.PubMedCrossRefGoogle Scholar
- 11.Nieuwkerk PT, Sprangers MA, Burger DM, et al.: Limited patient adherence to highly active antiretroviral therapy for HIV-1 infection in an observational cohort study. Arch Intern Med 2001, 161:1962–1968.PubMedCrossRefGoogle Scholar
- 12.Pradier C, Carrieri P, Bentz L, et al.: Impact of short-term adherence on virological and immunological success of HAART: a case study among French HIV-infected IDUs. Int J STD AIDS 2001, 12:324–328.PubMedCrossRefGoogle Scholar
- 13.de la Rosa R, Ruiz-Mateos E, Rubio A, et al.: Long-term virological outcome and resistance mutations at virological rebound in HIV-infected adults on protease inhibitor-sparing highly active antiretroviral therapy. J Antimicrob Chemother 2004, 53:95–101.PubMedCrossRefGoogle Scholar
- 14.Holzemer WL, Corless IB, Nokes KM, et al.: Predictors of self-reported adherence in persons living with HIV disease. AIDS Patient Care STDS 1999, 13:185–197.PubMedGoogle Scholar
- 15.Bangsberg DR, Moss AR, Deeks SG: Paradoxes of adherence and drug resistance to HIV antiretroviral therapy. J Antimicrob Chemother 2004, 53:696–699.PubMedCrossRefGoogle Scholar
- 16.Sethi AK, Celentano DD, Gange SJ, et al.: Association between adherence to antiretroviral therapy and human immunodeficiency virus drug resistance. Clin Infect Dis 2003, 37:1112–1118.PubMedCrossRefGoogle Scholar
- 17.Belzer ME, Fuchs DN, Luftman GS, et al.: Antiretroviral adherence issues among HIV-positive adolescents and young adults. J Adolesc Health 1999, 25:316–319.PubMedCrossRefGoogle Scholar
- 18.Rigsby MO, Rosen MI, Beauvais JE, et al.: Cue-dose training with monetary reinforcement: pilot study of an antiretroviral adherence intervention. J Gen Intern Med 2000, 15:841–847.PubMedCrossRefGoogle Scholar
- 19.Singh N, Berman SM, Swindells S, et al.: Adherence of human immunodeficiency virus-infected patients to antiretroviral therapy. Clin Infect Dis 1999, 29:824–830.PubMedCrossRefGoogle Scholar
- 20.Spire B, Duran S, Souville M, et al.: Adherence to highly active antiretroviral therapies (HAART) in HIV-infected patients: from a predictive to dynamic approach. Soc Sci Med 2002, 54:1481–1496.PubMedCrossRefGoogle Scholar
- 21.Pach A 3rd, Cerbone FG, Gerstein DR.: A qualitative investigation of antiretroviral therapy among injection drug users. AIDS Behav 2003, 7:87–100.PubMedCrossRefGoogle Scholar
- 22.Ross L, Lim ML, Liao Q, et al.: Prevalence of antiretroviral drug resistance and resistance-associated mutations in antiretroviral therapy-naive HIV-infected individuals from 40 United States cities. HIV Clin Trials 2007, 8:1–8.PubMedCrossRefGoogle Scholar
- 23.SPREAD programme: Transmission of drug-resistant HIV-1 in Europe remains limited to single classes. AIDS 2008, 22:625–635.CrossRefGoogle Scholar
- 24.Wainberg MA, Friedland G: Public health implications of antiretroviral therapy and HIV drug resistance. JAMA 1998, 279:1977–1983.PubMedCrossRefGoogle Scholar
- 25.Gardner EM, Sharma S, Peng G, et al.: Differential adherence to combination antiretroviral therapy is associated with virological failure with resistance. AIDS 2008, 22:75–82.PubMedGoogle Scholar
- 26.Kahn JO, Walker BD: Acute human immunodeficiency virus type 1 infection. N Engl J Med 1998, 339:133–139.CrossRefGoogle Scholar
- 27.Moatti JP, Souteyrand Y: HIV/AIDS social and behavioural research: past advances and thoughts about the future. Soc Sci Med 2000, 50:1519–1532.PubMedCrossRefGoogle Scholar
- 28.Maggiolo F, Airoldi M, Kleinloog HD, et al.: Effect of adherence to HAART on virologic outcome and on the selection of resistance-conferring mutations in NNRTI-or PI-treated patients. HIV Clin Trials 2007, 8:282–292.PubMedCrossRefGoogle Scholar
- 29.Perno CF, Moyle G, Tsoukas C, et al.: Overcoming resistance to existing therapies in HIV-infected patients: the role of new antiretroviral drugs. J Med Virol 2008, 80:565–576.PubMedCrossRefGoogle Scholar
- 30.Chesney MA, Farmer P, Leander F, et al.: Human immunodeficiency virus and acquired immunodeficiency syndrome. In Adherence to Long-Term Therapies: Evidence for Action. Edited by Sabate E. Geneva: World Health Organization; 2003:95–106.Google Scholar
- 31.Kelly JA, Otto-Salaj LL, Sikkema KJ, et al.: Implications of HIV treatment advances for behavioral research on AIDS: protease inhibitors and new challenges in HIV secondary prevention. Health Psychol 1998, 17:310–319.PubMedCrossRefGoogle Scholar
- 32.Duran S, Spire B, Raffi F, et al.: Self-reported symptoms after initiation of a protease inhibitor in HIV-infected patients and their impact on adherence to HAART. HIV Clin Trials 2001, 2:38–45.PubMedCrossRefGoogle Scholar
- 33.Tseng A, Foisy M, Fletcher D: Handbook of HIV Drug Therapy. Toronto: The Toronto Hospital; 1998.Google Scholar
- 34.Chesney MA, Ickovics J, Hecht FM, et al.: Adherence: a necessity for successful HIV combination therapy. AIDS 1999, 13(Suppl A):S271–S278.PubMedGoogle Scholar
- 35.Chesney MA, Morin M, Sherr L: Adherence to HIV combination therapy. Soc Sci Med 2000, 50:1599–1605.PubMedCrossRefGoogle Scholar
- 36.Munro S, Lewin S, Swart T, Volmink J: A review of health behaviour theories: how useful are these for developing interventions to promote long-term medication adherence for TB and HIV/AIDS? BMC Public Health 2007, 7:104.PubMedCrossRefGoogle Scholar
- 37.Fisher JD, Fisher WA, Amico R, Harman JJ: An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychol 2006, 25:462–473.PubMedCrossRefGoogle Scholar
- 38.Miller WR, Rollnick S. Motivational Interviewing: Preparing People to Change Addictive Behavior. New York: Guilford Press; 1991.Google Scholar
- 39.Pearson CR, Micek MA, Simoni JM, et al.: Modified directly observed therapy to facilitate highly active antiretroviral therapy adherence in Beira, Mozambique: development and implementation. J Acquir Immune Defic Syndr 2006, 43:S134–S141.PubMedCrossRefGoogle Scholar
- 40.Pearson CR, Micek MA, Simoni JM, et al.: Randomized control trial of peer-delivered, modified directly observed therapy for HAART in Mozambique. J Acquir Immune Defic Syndr 2007, 46:238–244.PubMedCrossRefGoogle Scholar
- 41.Fisher JD, Fisher WA: Changing AIDS risk behavior. Psychol Bull 1992, 111:455–474.PubMedCrossRefGoogle Scholar
- 42.Amico KR, Toro-Alfonso J, Fisher JD: An empirical test of the information, motivation, behavioral skills model of antiretroviral therapy adherence. AIDS Care 2005, 17:661–673.PubMedCrossRefGoogle Scholar
- 43.Starace F, Massa A, Amico KR, Fisher JD: Adherence to antiretroviral therapy: an empirical test of the information-motivation-behavioral skills model. Health Psychology 2006, 25:153–162.PubMedCrossRefGoogle Scholar
- 44.Amico KR, Barta W, Konkle-Parker DJ, et al.: The information-motivation-behavioral skills model of ART adherence in a Deep South HIV positive clinic sample. AIDS Behav 2007 Sep 18 [Epub ahead of print].Google Scholar
- 45.Margolin A, Avants S, Warburton L, et al.: A randomized clinical trial of a manual-guided risk reduction intervention for HIV-positive injection drug users. Health Psychol 2003, 22:223–228.PubMedCrossRefGoogle Scholar
- 46.Kalichman S, Cherry J, Cain D: Nurse-delivered antiretroviral treatment adherence intervention for people with low literacy skills and living with HIV/AIDS. J Assoc Nurses AIDS Care 2005, 16:3–15.PubMedGoogle Scholar
- 47.Mannheimer SB, Morse E, Matts JP, et al.: Community programs for clinical research on AIDS. Sustained benefit from a long-term antiretroviral adherence intervention. Results of a large randomized clinical trial. J Acquir Immune Defic Syndr 2006, 43(Suppl 1):S41–S47.PubMedGoogle Scholar
- 48.Wagner G, Kanouse D, Golinelli D, et al.: Cognitive-behavioral intervention to enhance adherence to antiretroviral therapy: a randomized controlled trial (CCTG 578). AIDS 2006, 20:1295–1302.PubMedCrossRefGoogle Scholar
- 49.Parsons JT, Golub SA, Rosof E, et al.: Motivational interviewing and cognitive-behavioral intervention to improve HIV medication adherence among hazardous drinkers: a randomized controlled trial. J Aquir Immune Defic Syndr 2007, 46:433–450.Google Scholar
- 50.Ware NC, Wyatt MA, Bangsberg DR: Examining theoretical models of adherence for validity in resource-limited settings: a heuristic approach. J Acquir Immune Defic Syndr 2006, 43(Suppl 1):S18–S22.PubMedGoogle Scholar
- 51.Haberer J: Measurement of adherence to ART in HIV-infected school-aged children in Uganda. National Institute of Mental Health grant 1R21MH083306-01. March 14, 2008.Google Scholar
- 52.Kalichman SC: HIV treatment adherence/risk reduction integrated. National Institute of Mental Health grant 5R01MH071164-04. April 1, 2005.Google Scholar
- 53.Catz S: Patient portal to support treatment adherence. National Institute of Mental Health grant 1R01MH081750-01A1. July 7, 2008.Google Scholar
- 54.Cornman DH, Christie S, Amico KR, et al.: Options Intervention Protocol Manual: A Step-by-Step Guide to Risk Reduction Counseling with PLWHA. Available at http://www.chip.uconn.edu/int/Protocol%20Manual%20designed%206-28-07%20COMPLETE%20for%20WEB.pdf. Accessed August 2008.
- 55.Fisher JD, Fisher WA, Cornman, DH, et al.: Cliniciandelivered intervention during routine clinical care reduces unprotected sexual behavior among HIV-infected patients. J Aquir Immune Defic Syndr 2006, 41:44–52.CrossRefGoogle Scholar
- 56.Prochaska JO, DiClemente CC, Norcross JC: In search of how people change: applications to addictive behaviors. Am Psychol 1992, 42:1112–1114.Google Scholar