Information-Motivation-Behavioral Skills Barriers Associated With Intentional Versus Unintentional ARV Non-Adherence Behavior Among HIV-Positive Patients in Clinical Care

Thanks to antiretroviral (ARV) therapy, "HIV has become better characterized as a chronic disease rather than a terminal illness, depending in part on one's ability to maintain relatively high levels of adherence," the authors wrote. Research has explored barriers and facilitators of ARV adherence behavior; however, "relatively little is known about specific challenges faced by HIV-positive persons who report 'taking a break' from their ARV medications."

In the current study, the researchers used the "Information-Motivation-Behavioral Skills Model" of ARV adherence to examine the adherence-related barriers that may differentiate non-adherent patients who report "taking a break" from ARVs versus those who do not report doing so.

A population of 327 HIV-positive patients reporting less than 100 percent adherence at baseline was studied. Patients classified as intentionally non-adherent were those who reported "taking a break" from their medications without first discussing their plans with a health care provider. Non-adherent patients who did not report "taking a break" were classified as unintentionally non-adherent. The differences between these two populations -- with respect to demographic characteristics and responses to the adherence-related information, motivation, and behavioral skills questions -- were analyzed.

The results revealed few differences among the groups in demographics, adherence-related information or adherence-related motivation; "however, significant differences were observed on about half of the adherence-related behavioral skills items," the authors reported.

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