Krishnan Archana, Ranjit Yerina S, Zhou Xin, Altice Frederick L
Department of Communication, University at Albany, State University of New York, Albany, New York, USA.
Department of Communication, University of Missouri, Columbia, Missouri, USA.
J Behav Med. 2025 Jun;48(3):403-413. doi: 10.1007/s10865-025-00557-y. Epub 2025 Feb 9.
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.
抗逆转录病毒疗法（ART）在降低艾滋病毒传播和死亡率方面是有效的，但对于许多艾滋病毒感染者（PWH）来说，每日坚持服药仍然是一项挑战。依从性欠佳会导致病毒学治疗失败和死亡率增加，尤其是在那些患有物质使用障碍的人群中，比如可卡因使用障碍（CUD）。信息-动机-行为（IMB）技能模型提供了一个框架，通过解决个人和社会障碍来理解和增强对抗逆转录病毒疗法的依从性。在本研究中，我们在80名目前正在接受抗逆转录病毒治疗的可卡因使用PWH中测试了IMB技能模型，发现行为技能显著预测了依从性。在IMB技能模型的扩展中，增加实际障碍改变了这种关系，表明诸如治疗疲劳等动机障碍和实际障碍显著影响了抗逆转录病毒疗法的依从性。研究结果表明，对于患有物质使用障碍的PWH，除了培养行为技能外，解决实际障碍和动机因素可能对提高抗逆转录病毒疗法的依从性至关重要。
