HIV remains a major public health issue, despite advances in highly active antiretroviral therapy (HAART) to prevent viral replication. Strict adherence to HAART is necessary for achieving effects, as insufficient HAART adherence has been associated with increases in HIV viral load, the development of drug resistant strains of HIV and increased mortality. New guidelines for the prescription of HAART recommend initiating HAART earlier, but factors such as drug use and depression are associated with poor adherence. Validated methods for improving HAART adherence are needed. The Information-Motivation-Behavioral Skills (IMB) model of behavior change, which has been validated in other applications, has recently been applied to antiretroviral adherence, demonstrating efficacy in early studies (Fisher & Fisher, 2006). According to the IMB model of behavior change, information about the medication regimen alone is insufficient for behavior change. Motivation and behavioral skills regarding adherence must also be enhanced as well. IMB-based interventions have shown promise with non-drug using populations, but the model has not been extended to work with a population that is actively using a variety of illicit drugs and can benefit considerably from improved adherence interventions. This project will (1) examine the acceptability and feasibility of an IMB intervention with active drug using HIV-positive individuals demonstrating poor HAART adherence, (2) estimate the effect size of an IMB intervention with active drug using HIV-positive individuals demonstrating poor HAART adherence, and (3) assess client satisfaction with an IMB intervention.

Public Health Relevance Statement:

HIV remains a public health issue. Strict adherence to highly active antiretroviral therapy (HAART) is necessary and adherence-improving interventions are needed for active drug users. The Information-Motivation-Behavioral Skills (IMB) model of behavior change is a promising method of improving HAART adherence, but needs further examination to determine its efficacy in active drug users.