Predictive Relationship of Drug-Abstinence Self-Efficacy, Health Locus of Control, Drug Use Severity, and HIV Severity on Readiness to Change Among Out-of-Treatment HIV+ Drug Users

A dearth of research exists on out-of-treatment drug users with co-occurring HIV despite the inextricable link between these two health problems and ongoing transmission of HIV. This study examined the predictive strength, quality, and nature of factors associated with readiness to change drug use among out-of-treatment HIV-positive drug-users. Understanding factors that influence readiness to change drug use will aid in the development of effective public health and outreach strategies for engaging this under-served population to affect change in their drug use and thus reduce potential for continued engagement in high risk behaviors that contribute to ongoing HIV transmission. Data were obtained from 165 participants from Alabama, Tennessee, and Georgia using a self-report instrument that included brief demographics and drug use questionnaires, Leeds Dependence Questionnaire, Drug Abstinence Self-Efficacy Scale, Multidimensional Health Locus of Control Scale, University of Rhode Island Change Assessment, and last known CD4+ cell count. Significant positive relationships existed between internal health locus of control, drug use severity, and readiness to change. Significant negative relationships existed between drug abstinence self-efficacy, HIV severity, and readiness to change. Multiple regression analyses indicated that IHLoC, drug abstinence self-efficacy, and HIV severity correctly predicted 14.9% of the variance in readiness to change. Finally, drug use severity had a significant moderating effect on self-efficacy. Follow-up analyses revealed that African American participants scored significantly higher than Caucasian participants on readiness to change.