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Predicting antiretroviral medication adherence among substance-using people with HIV: test and extension of the information-motivation-behavioral skills model.

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Title: Predicting antiretroviral medication adherence among substance-using people with HIV: test and extension of the information-motivation-behavioral skills model.
Authors: Krishnan A; Department of Communication, University at Albany, State University of New York, Albany, New York, USA. archana.krishnan@aya.yale.edu., Ranjit YS; Department of Communication, University of Missouri, Columbia, Missouri, USA., Zhou X; Department of Internal Medicine, Section of Infectious Diseases, Yale University, New Haven, Connecticut, USA., Altice FL; Department of Internal Medicine, Section of Infectious Diseases, Yale University, New Haven, Connecticut, USA.
Source: Journal of behavioral medicine [J Behav Med] 2025 Jun; Vol. 48 (3), pp. 403-413. Date of Electronic Publication: 2025 Feb 09.
Publication Type: Journal Article; Research Support, N.I.H., Extramural
Language: English
Journal Info: Publisher: Springer Science + Business Media Country of Publication: United States NLM ID: 7807105 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-3521 (Electronic) Linking ISSN: 01607715 NLM ISO Abbreviation: J Behav Med Subsets: MEDLINE
Imprint Name(s): Publication: <2008->: New York, NY : Springer Science + Business Media
Original Publication: New York, Plenum Press.
MeSH Terms: HIV Infections*/drug therapy , HIV Infections*/psychology , HIV Infections*/complications , Medication Adherence*/psychology , Cocaine-Related Disorders*/psychology , Cocaine-Related Disorders*/complications , Anti-HIV Agents*/therapeutic use , Substance-Related Disorders*/psychology , Motivation* , Models, Psychological*, Humans ; Male ; Female ; Adult ; Middle Aged ; Information Motivation Behavioral Skills Model
Abstract: Antiretroviral therapy (ART) is effective in reducing HIV transmission and mortality, yet daily adherence remains a challenge for many people with HIV (PWH). Suboptimal adherence can lead to virological failure and increased mortality, particularly among those with substance use disorders, such as cocaine use disorder (CUD). The Information-Motivation-Behavioral (IMB) skills model offers a framework to understand and enhance ART adherence by addressing individual and social barriers. In this study, we tested the IMB skills model among 80 cocaine-using PWH currently on ART, and found that behavioral skills significantly predicted adherence. In the extension of the IMB skills model, the addition of practical barriers altered the relationship by showing that motivational barriers such as treatment fatigue and practical barriers significantly affected ART adherence. The findings suggest that for PWH with substance use disorders, addressing practical barriers and motivational factors may be crucial for improving ART adherence, in addition to building behavioral skills.
(© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Competing Interests: Declarations. Ethics approval: All procedures including informed consent forms were approved by the Human Investigation Committee (HIC) board at Yale University (Protocol #1508016342). Consent for publication: Not applicable. Competing interests: The authors declare that they have no known competing financial interests or personal relationships that can influence the work reported in this paper.
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Grant Information: R21 DA039842 United States DA NIDA NIH HHS; DA039842 Intramural Research Program, National Institute on Drug Abuse
Contributed Indexing: Keywords: Barriers to medication; Cocaine; Information-motivation-behavioral skills model; Medication adherence; People with HIV
Substance Nomenclature: 0 (Anti-HIV Agents)
Entry Date(s): Date Created: 20250209 Date Completed: 20250515 Latest Revision: 20260726
Update Code: 20260726
DOI: 10.1007/s10865-025-00557-y
PMID: 39924604
Database: MEDLINE
Description
ISSN:1573-3521
DOI:10.1007/s10865-025-00557-y