Journal of Education and Health Promotion

Abstract BACKGROUND: HIV‑infected patients with poor antiretroviral therapy (ART) adherence are prone
to depression, and depression can exacerbate the disease condition. This study was conducted to
determine ART Adherence based on Information, Motivation, and Behavioral Skills (IMB) Model and
its association with depression among HIV‑positive patients.
MATERIALS AND METHODS: This descriptive–correlational study was carried out on people over
the age of 18 years with HIV/AIDS, who referred to the Behavioral Diseases Counseling Center in
Kerman City, Iran, in 2017. In this regard, 119 patients were selected using the table of random
numbers. To collect the data, we used the Beck’s depressioninventory‑II and the IMB researcher
made questionnaire to evaluate the ART adherence.
RESULTS: The results of the study reveal that a significant association was observed between the
total adherence and all constructs of the IMB model (P < 0.001). Risk perception and self‑efficacy had
the highest mean scores regarding the ART adherence. The prevalence of depression was 71.5%
among patients. Information, personal motivation, and total adherence had a significant association
with depression.
CONCLUSIONS: IMB model was an appropriate and practical strategy with regard to the ART
adherence among people living with HIV who are prone to depression and drug consumption is crucial
for them to achieve the 90‑90‑90 target. This article created a questionnaire to assist policy‑makers
and health professionals designing interventions to improve adherence and health outcomes of ART.

Abstract INTRODUCTION: A sharp increase in expenditure is one of the challenges of the health system
in Iran. Every macroeconomic variable affects health, and if it is disregarded, it will lead to higher
macrobudgets. Physical and mental health as well as the use of health services change according
to the macroeconomic conditions and business cycles (boom and recession). The present study
aimed to determine the effect of macroeconomic indicators on health expenditure.
METHODS: This study was descriptive analytical. The required data related to macroeconomic
indicators and health expenditure in public and private sectors were collected during 1995–2014.
The data were analyzed using the time series models in econometrics, Vector Auto Regression,
and Granger causality technique.
RESULTS: The results of this study indicated that health expenditure has a positive bilateral
relationship with gross domestic production (GDP), gross national production, national income,
and national consumption. On the contrary, expenditure has a negative bilateral relationship with
liquidity rate and inflation rate. In addition, budget deficit has a negative unilateral relationship with
health expenditure while population rate has a positive unilateral relationship with health expenditure.
CONCLUSION: The results of this study indicated the increase of health expenditure in Iran that
GDP is the most critical determining factor of health expenditure. In general, the total expenditure in
the health sector in the world increases when the countries become richer. In line with the increase
of resources, innovative financing methods and efficiency improvement are required for providing
basic health services in low‑income countries.