Adherence Motivational Factors of HIV Highly Active Antiretroviral Therapy among African Americans living in New York City

Purpose: The study assessed whether motivation is a significant predictive factor of Highly Active Antiretroviral Therapy (HAART) treatment as postulated by the Information–Motivation–Behavioral skills (IMB) model of HAART adherence in a cross sectional sample of 329 HIV-positive African American residents of New York City. Objectives: Adherence deficits prevent African Americans from optimizing HAART related benefits at rates parallel to their racial/ethnic counterparts. Concordance between HAART related information, behavior skills, demographic factors, and adherence rates were evaluated. The results are critical to enhancing adherence strategies among African Americans. Methods: Regression analyses were conducted at a statistical significance threshold of p < .05: 1. Cronbach's Alpha determined internal consistency reliability. Research questions examined interrelationships between IMB skills constructs and specific demographic characteristics. Dependent variable was percent adherence to HAART. Primary predictor variable was HAART Motivation (Hypothesis 1). Secondary predictor variables were HAART Information and HAART Behavior (Hypothesis 2). Exploratory covariates included age, marital status, and education (Hypothesis 3). The overall multiple regression model accounted for 61% of the variance in adherence (R2 = .61). This predictive model was statistically significant, F (8,320) = 62.0, p < .00001. Result: Information and behavioral skills were significant, positive predictors of adherence, while Motivation was a significant negative, not positive predictor of adherence. Demographic characteristics had varying predictive values to HAART adherence. Conclusion: Theory based interventions to enhance African Americans adherence levels will likely be most effective with a greater focus on providing information and enhanced medication taking skills,than focus on mere motivation.