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AIDS and Behavior

, Volume 21, Issue 5, pp 1299–1308 | Cite as

Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment

  • Roman Shrestha
  • Frederick L. Altice
  • Tania B. Huedo-Medina
  • Pramila Karki
  • Michael Copenhaver
Original Paper

Abstract

Evidence from recent pre-exposure prophylaxis (PrEP) trials has demonstrated its safety and efficacy in significantly reducing the risk of HIV acquisition for those who are at considerable risk of acquiring HIV infection. With a rapid increase in the amount of research on the efficacy of PrEP for HIV prevention, complementary research on the willingness to use PrEP has grown, especially among MSM, but limited research has been focused among people who use drugs (PWUD). As part of the formative process, we utilized the information-motivation-behavioral skills (IMB) model of health behavior change to characterize and guide intervention development for promoting willingness to use PrEP among high-risk PWUD. The analysis included 400 HIV-negative high-risk PWUD enrolled in a community-based methadone maintenance treatment who reported drug- and/or sex-related HIV risk behaviors in the past 6-months. Analyses revealed support for the IMB model as PrEP-related behavioral skills were found to mediate the influence of PrEP-related information and motivation on willingness to use PrEP. The results provide evidence as to the utility of the IMB model to increase willingness to use PrEP among high-risk PWUD. It therefore makes an important contribution to our understanding of the applicability of theoretically-grounded models of willingness to use PrEP among high-risk PWUD, who are one of the key risk populations who could benefit from the use of PrEP.

Keywords

Pre-exposure prophylaxis People who use drugs Substance use IMB model HIV Structural equation modeling 

Notes

Funding

This work was supported by grants from the National Institute on Drug Abuse for research (R01 DA025943 to FLA) and for career development (K24 DA017072 to FLA; K02 DA033139 to MMC).

Compliance with Ethical Standards

Conflicts of interest

The authors have no conflicts of interest to disclose.

Ethical Approval

The study protocol was approved by the Investigational Review Board (IRB) at the University of Connecticut and received board approval from APT Foundation Inc. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    CDC. HIV surveillance report: diagnoses of HIV infection in the United States and dependent areas, 2015, vol. 27. Atlanta: CDC; 2016.Google Scholar
  2. 2.
    Arasteh K, Jarlais DCD, Perlis TE. Alcohol and HIV sexual risk behaviors among injection drug users. Drug Alcohol Depend. 2008;95(1):54–61.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Marshall BDL, Friedman SR, Monteiro JFG, Paczkowski M, Tempalski B, Pouget ER, Lurie MN, Galea S. Prevention and treatment produced large decreases in HIV incidence in a model of people who inject drugs. Health Aff. 2014;33(3):401–9.CrossRefGoogle Scholar
  4. 4.
    Strathdee SA, Hallett TB, Bobrova N, Rhodes T, Booth R, Abdool R, Hankins CA. HIV and risk environment for injecting drug users: the past, present, and future. Lancet. 2010;376(9737):268–84.CrossRefPubMedGoogle Scholar
  5. 5.
    Volkow ND, Montaner J. The urgency of providing comprehensive and integrated treatment for substance abusers with HIV. Health Aff. 2011;30(8):1411–9.CrossRefGoogle Scholar
  6. 6.
    Shrestha R, Krishnan A, Altice FL, Copenhaver M. A non-inferiority trial of an evidence-based secondary HIV prevention behavioral intervention compared to an adapted, abbreviated version: rationale and intervention description. Contem Clin Trials. 2015;44:95–102.CrossRefGoogle Scholar
  7. 7.
    Shrestha R, Copenhaver M. The influence of neurocognitive impairment on HIV risk behaviors and intervention outcomes among high-risk substance users: a systematic review. Front Public Health. 2016;4:16.PubMedPubMedCentralGoogle Scholar
  8. 8.
    CDC. Preexposure prophylaxis for the prevention of HIV infection in the United States—2014: a clinical practice guideline. Washington, DC: Department of Health and Human Services USA—Centers for Disease Control and Prevention; 2014.Google Scholar
  9. 9.
    Kelesidis T, Landovitz RJ. Preexposure prophylaxis for HIV prevention. Curr HIV/AIDS Rep. 2011;8(2):94–103.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, Goicochea P, Casapía M, Guanira-Carranza JV, Ramirez-Cardich ME, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, Tappero JW, Bukusi EA, Cohen CR, Katabira E, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367(5):399–410.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Thigpen MC, Kebaabetswe PM, Paxton LA, Smith DK, Rose CE, Segolodi TM, Henderson FL, Pathak SR, Soud FA, Chillag KL, et al. Antiretroviral Preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367(5):423–34.CrossRefPubMedGoogle Scholar
  13. 13.
    Van Damme L, Corneli A, Ahmed K, Agot K, Lombaard J, Kapiga S, Malahleha M, Owino F, Manongi R, Onyango J, et al. Preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2012;367(5):411–22.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Choopanya K, Martin M, Suntharasamai P, Sangkum U, Mock PA, Leethochawalit M, Chiamwongpaet S, Kitisin P, Natrujirote P, Kittimunkong S, et al. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2013;381(9883):2083–90.CrossRefPubMedGoogle Scholar
  15. 15.
    WHO. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Geneva: WHO; 2015.Google Scholar
  16. 16.
    Young I, McDaid L. How acceptable are antiretrovirals for the prevention of sexually transmitted HIV?: A review of research on the acceptability of oral pre-exposure prophylaxis and treatment as prevention. AIDS Behav. 2014;18(2):195–216.CrossRefPubMedGoogle Scholar
  17. 17.
    King HL, Keller SB, Giancola MA, Rodriguez DA, Chau JJ, Young JA, Little SJ, Smith DM. Pre-exposure prophylaxis accessibility research and evaluation (PrEPARE Study). AIDS Behav. 2014;18(9):1722–5.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Cohen SE, Vittinghoff E, Bacon O, Doblecki-Lewis S, Postle BS, Feaster DJ, Matheson T, Trainor N, Blue RW, Estrada Y, et al. High interest in preexposure prophylaxis among men who have sex with men at risk for HIV infection: baseline data from the US PrEP demonstration project. J Acquir Immune Defic Syndr. 2015;68(4):439–48.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Hood JE, Buskin SE, Dombrowski JC, Kern DA, Barash EA, Katzi DA, Golden MR. Dramatic increase in preexposure prophylaxis use among MSM in Washington state. AIDS. 2016;30(3):515–9.PubMedGoogle Scholar
  20. 20.
    Peng B, Yang X, Zhang Y, Dai J, Liang H, Zou Y, Luo J, Peng H, Zhong X, Huang A. Willingness to use pre-exposure prophylaxis for HIV prevention among female sex workers: a cross-sectional study in China. HIV/AIDS (Auckl). 2012;4:149–58.Google Scholar
  21. 21.
    Hoagland B, De Boni RB, Moreira RI, Madruga JV, Kallas EG, Goulart SP, Cerqueira N, Torres TS, Luz PM, Fernandes NM, et al. Awareness and willingness to use pre-exposure prophylaxis (PrEP) among men who have sex with men and transgender women in Brazil. AIDS Behav. 2016. doi: 10.1007/s10461-016-1516-5.PubMedGoogle Scholar
  22. 22.
    Goedel WC, Halkitis PN, Greene RE, Duncan DT. Correlates of awareness of and willingness to use pre-exposure prophylaxis (PrEP) in gay, bisexual, and other men who have sex with men who use geosocial-networking smartphone applications in New York City. AIDS Behav. 2016;20(7):1435–42.CrossRefPubMedGoogle Scholar
  23. 23.
    Kuo I, Olsen H, Patrick R, Phillips G II, Magnus M, Opoku J, Rawls A, Peterson J, Hamilton F, Kharfen M, et al. Willingness to use HIV pre-exposure prophylaxis among community-recruited, older people who inject drugs in Washington, DC. Drug Alcohol Depend. 2016;164:8–13.CrossRefPubMedGoogle Scholar
  24. 24.
    Young I, Li J, McDaid L. Awareness and willingness to use HIV Pre-exposure prophylaxis amongst gay and bisexual men in Scotland: implications for biomedical HIV prevention. PLoS ONE. 2013;8(5):e64038.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Gredig D, Uggowitzer F, Hassler B, Weber P, Nideröst S. Acceptability and willingness to use HIV pre-exposure prophylaxis among HIV-negative men who have sex with men in Switzerland. AIDS Care. 2016;28(sup1):44–7.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Stein M, Thurmond P, Bailey G. Willingness to use HIV pre-exposure prophylaxis among opiate users. AIDS Behav. 2014;18(9):1694–700.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Ferrer L, Folch C, Fernandez-Davila P, Garcia A, Morales A, Belda J, Susperregui A, Casabona J. Awareness of pre-exposure prophylaxis for HIV, willingness to use it and potential barriers or facilitators to uptake among men who have sex with men in Spain. AIDS Behav. 2016;20:1423–33.CrossRefPubMedGoogle Scholar
  28. 28.
    Fisher JD, Fisher WA. Changing AIDS-risk behavior. Psychol Bull. 1992;111(3):455–74.CrossRefPubMedGoogle Scholar
  29. 29.
    Fisher JD, Fisher WA, Amico KR, Harman JJ. An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychol. 2006;25(4):462–73.CrossRefPubMedGoogle Scholar
  30. 30.
    Bian C, Xu S, Wang H, Li N, Wu J, Zhao Y, Li P, Lu H. A study on the application of the information-motivation-behavioral skills (IMB) model on rational drug use behavior among second-level hospital outpatients in Anhui, China. PLoS ONE. 2015;10(8):e0135782.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Fisher JD, Fisher WA, Bryan AD, Misovich SJ. Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth. Health Psychol. 2002;21(2):177–86.CrossRefPubMedGoogle Scholar
  32. 32.
    Fisher JD, Fisher WA, Williams SS, Malloy TE. Empirical tests of an information-motivation-behavioral skills model of AIDS-preventive behavior with gay men and heterosexual university students. Health Psychol. 1994;13(3):238–50.CrossRefPubMedGoogle Scholar
  33. 33.
    Ezeabogu I, Copenhaver MM, Potrepka J. The influence of neurocognitive impairment on HIV treatment outcomes among drug-involved people living with HIV/AIDS. AIDS Care. 2012;24(3):386–93.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Rongkavilit C, Naar-King S, Kaljee LM, Panthong A, Koken JA, Bunupuradah T, Parsons JT. Applying the information-motivation-behavioral skills model in medication adherence among Thai youth living with HIV: a qualitative study. AIDS Patient Care STDs. 2010;24(12):787–94.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Mayberry LS, Osborn CY. Empirical validation of the information-motivation-behavioral skills model of diabetes medication adherence: a framework for intervention. Diabetes Care. 2014;37(5):1246–53.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Chang SJ, Choi S, Kim SA, Song M. Intervention strategies based on information-motivation-behavioral skills model for health behavior change: a systematic review. Asian Nurs Res. 2014;8(3):172–81.CrossRefGoogle Scholar
  37. 37.
    Huedo-Medina TB, Shrestha R, Copenhaver M. Modeling a theory-based approach to examine the influence of neurocognitive impairment on HIV risk reduction behaviors among drug users in treatment. AIDS Behav. 2016;20(8):1646–57.CrossRefPubMedGoogle Scholar
  38. 38.
    Shrestha R, Huedo-Medina T, Krishnan A, Altice F, Copenhaver M. Examining the acceptability of mHealth technology in HIV prevention among high-risk drug users in treatment. AIDS Behav. 2016.Google Scholar
  39. 39.
    Copenhaver MM, Lee IC, Baldwin P. A randomized controlled trial of the community-friendly health recovery program (CHRP) among high-risk drug users in treatment. AIDS Behav. 2013;17(9):2902–13.CrossRefPubMedGoogle Scholar
  40. 40.
    Ward J, Darke S, Hall W. The HIV risk-taking behaviour scale (HRBS) manual. Sydney: National Drug and Alcohol Research Centre, University of New South Wales; 1999.Google Scholar
  41. 41.
    Shrestha R, Huedo-Medina T, Altice F, Karki P, Copenhaver M. Correlates of willingness to use pre-exposure prophylaxis (PrEP) and the likelihood of practicing safer drug- and sex-related risk behaviors while on PrEP among high-risk drug users in treatment. Drug Alcohol Depend. 2016.Google Scholar
  42. 42.
    Schafer JL, Graham JW. Missing data: our view of the state of the art. Psychol Methods. 2002;7(2):147–77.CrossRefPubMedGoogle Scholar
  43. 43.
    Muthén BO, Muthén LK. Mplus user’s guide. 7th ed. Los Angeles: Muthén & Muthén; 2012.Google Scholar
  44. 44.
    Arbuckle JL, Marcoulides GA, Schumacker RE. Full information estimation in the presence of incomplete data. Adv Struct Equ Model Issues Tech. 1996;243:277.Google Scholar
  45. 45.
    Barrett P. Structural equation modelling: adjudging model fit. Personal Individ Differ. 2007;42(5):815–24.CrossRefGoogle Scholar
  46. 46.
    Bentler PM. Comparative fit indexes in structural models. Psychol Bull. 1990;107(2):238–46.CrossRefPubMedGoogle Scholar
  47. 47.
    Tucker L, Lewis C. A reliability coefficient for maximum likelihood factor analysis. Psychometrika. 1973;38(1):1–10.CrossRefGoogle Scholar
  48. 48.
    Steiger JH. Structural model evaluation and modification: an interval estimation approach. Multivar Behav Res. 1990;25(2):173–80.CrossRefGoogle Scholar
  49. 49.
    Byrne BM. Structural equation modeling with LISREL, PRELIS, and SIMPLIS: Basic concepts, applications, and programming. New York: Psychology Press; 2013.Google Scholar
  50. 50.
    Diamantopoulos A, Siguaw JA, Siguaw JA. Introducing LISREL: A guide for the uninitiated. Thousand Oaks: Sage; 2000.CrossRefGoogle Scholar
  51. 51.
    Santillán Torres Torija C, Villagrán Vázquez G, Robles Montijo SS, de Lourdes Eguiluz Romo L. The information and motivation and behavioral skills model of ART adherence among HIV-positive adults in Mexico. J Int Assoc Provid AIDS Care. 2015;14(4):335–42.CrossRefPubMedGoogle Scholar
  52. 52.
    Starace F, Massa A, Amico KR, Fisher JD. Adherence to antiretroviral therapy: an empirical test of the information-motivation-behavioral skills model. Health Psychol. 2006;25(2):153–62.CrossRefPubMedGoogle Scholar
  53. 53.
    Amico KR, Barta W, Konkle-Parker DJ, Fisher JD, Cornman DH, Shuper PA, Fisher WA. The information–motivation–behavioral skills model of ART adherence in a deep south HIV + clinic sample. AIDS Behav. 2009;13(1):66–75.CrossRefPubMedGoogle Scholar
  54. 54.
    Osborn CY, Egede LE. Validation of an information-motivation-behavioral skills model of diabetes self-care (IMB-DSC). Patient Educ Couns. 2010;79(1):49–54.CrossRefPubMedGoogle Scholar
  55. 55.
    Zhu C, Cai Y, Ma J, Li N, Zhu J, He Y, Redmon P, Qiao Y. Predictors of intention to smoke among junior high school students in Shanghai, China: an empirical test of the information-motivation-behavioral skills (IMB) model. PLoS ONE. 2013;8(11):e80482.CrossRefPubMedPubMedCentralGoogle Scholar
  56. 56.
    Zhao YW, Wu JY, Wang H, Li NN, Bian C, Xu SM, Li P, Lu H, Xu L. A cross-sectional study assessing predictors of essential medicines prescribing behavior based on information-motivation-behavioral skills model among County Hospitals in Anhui, China. Chin Med J. 2015;128(21):2887–95.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Community Medicine and Health CareUniversity of Connecticut Health CenterFarmingtonUSA
  2. 2.Institute for Collaboration on Health, Intervention, and PolicyUniversity of ConnecticutStorrsUSA
  3. 3.Department of Internal Medicine, AIDS ProgramYale University School of MedicineNew HavenUSA
  4. 4.Department of Allied Health SciencesUniversity of ConnecticutStorrsUSA

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