Associations between Information-Motivation-Behavioral (IMB) variables and neurological functioning to predict risk behaviors among HIV-positive adults who use alcohol

The Information-Motivation-Behavioral Skills (IMB) model has been used to understand HIV risk and preventive behaviors. Adding a biological indicator such as neurological functioning could be an effective component, strengthening the explanatory power of the IMB model; neurological impairment has been associated with both HIV and alcohol abuse. We examined IMB variables (prosocial peer attitudes towards condom use, condom self-efficacy, and HIV knowledge) and relationships with antecedent variables—demographics, life stress, social support, and neurological impairment—on outcome measures of condom skills, risky sex behaviors, and recent alcohol use among HIV+ adult alcohol-users. The sample (n=250) was 35% female; mean age 44.83 years; mostly minority (71% Black/A.A., and 16% Hispanic). Bivariate analyses of baseline data revealed neurological impairment was more likely among older participants (.21, p< .001) and was associated with lower knowledge scores (-.28, p< .001) and poorer condom skills (-.30, p< .001). Greater life stress was associated with less social support (-.17, p< .05) and more risky sex behaviors (.21, p< .001). Social support and higher knowledge scores were associated with better condom skills (.18, p< .01 and .20, p< .001). Final path analysis showed neurological impairment to negatively predict knowledge scores (-.28) and condom skills (-.29). Prosocial peer attitudes were associated with less recent alcohol use (-.15). Greater life stress predicted more risky sex behaviors (.26). Social support predicted better condom skills (.17) and better condom skills predicted less recent alcohol use (.14). Prevention interventions geared toward HIV+ adults should take into account alcohol-related, age-related and HIV-related neurological functioning.