An empirical test of the information-motivation-behavioral skills model of ART adherence in a sample of HIV-positive persons primarily in out-of-HIV-care settings

Keith J. Horvath, Derek Smolenski, K. Rivet Amico

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

The current body of evidence supporting the Information-Motivation-Behavioral Skills (IMB) model of antiretroviral therapy (ART) adherence rests exclusively on data collected from people living with HIV (PLWH) at point-of-HIV-care services. The aims of this study were to: (1) determine if the IMB model is a useful predictive model of ART adherence among PLWH who were primarily recruited in out-of-HIV-care settings; and (2) assess whether the theorized associations between IMB model constructs and adherence persist in the presence of depression and current drug use. PLWH (n = 312) responding to a one-time online survey completed the Life Windows IMB-ART-Adherence Questionnaire, and demographic, depression (CES-D 10), and drug use items. Path models were used to assess the fit of a saturated versus fully mediated IMB model of adherence and examined for moderating effects of depression and current drug use. Participants were on average 43 years of age, had been living with HIV for 9 or more years, and mostly male (84.0%), Caucasian (68.8%), and gay-identified (74.8%). The a priori measurement models for information and behavioral skills did not have acceptable fit to the data and were modified accordingly. Using the revised IMB scales, IMB constructs were associated with adherence as predicted by the theory in all but one model (i.e., the IMB model operated as predicted among nondrug users and those with and without depression). Among drug users, information exerted a direct effect on adherence but was not significantly associated with behavioral skills. Results of this study suggest that the fully or partially mediated IMB model is supported for use with samples of PLWH recruited primarily out-of-HIV-care service settings and is robust in the presence of depression and drug use.

Original languageEnglish (US)
Pages (from-to)142-151
Number of pages10
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume26
Issue number2
DOIs
StatePublished - Jan 1 2014

Bibliographical note

Funding Information:
We wish to thank the participants of this study for their time and effort. This study was funded by the National Institute of Mental Health (5R34MH083549).

Keywords

  • ART adherence
  • Internet
  • behavioral theory
  • information-motivation-behavioral skills model
  • outside point-of-care settings

Fingerprint Dive into the research topics of 'An empirical test of the information-motivation-behavioral skills model of ART adherence in a sample of HIV-positive persons primarily in out-of-HIV-care settings'. Together they form a unique fingerprint.

Cite this