Document Type : Original Article
Authors
- . Mohammad Ali Morowatisharifabad1 1
- . Ehsan Movahed 2
- . Jamileh Farokhzadian 3
- . Rohollah Nikooie 4
- . Mohsen Askarishahi 5
- . Reza Bidaki 6
- . Mahdieh Hosseinzadeh 7
1 Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Health Education and Health Promotion, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran
3 Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
4 Department of Exercise Physiology, Faculty of Sports Sciences, Shahid Bahonar University, Kerman
5 Department of Biostatistics and Epidemiology, Shahid Sadoughi University of Medical Sciences
6 Research Center of Addiction and Behavioral Sciences and Diabetes Research Center, Shahid Sadoughi University of Medical Sciences
7 Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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.
Keywords
from: http://www.who.int/hiv/data/en/. [Last accessed on
2017 Aug 20].
2. Nasirian M, Haghdoost AA, Doroudi F, Gooya MM, Sedaghat A,
Rabbori ED. Modelling HIV modes of transmission in
Iran. Retrovirology. 2012;9(Suppl 1):121
3. Garbelli A, Riva V, Crespan E, Maga G. How to win the HIV‑1
drug resistance hurdle race: Running faster or jumping higher?
Biochem J 2017;474:1559‑77.
4. Sasaki Y, Kakimoto K, Dube C, Sikazwe I, Moyo C, Syakantu G,
et al. Adherence to antiretroviral therapy (ART) during the early
months of treatment in rural Zambia: Influence of demographic
characteristics and social surroundings of patients. Ann Clin
Microbiol Antimicrob 2012;11:34.
5. Mills EJ, Nachega JB, Buchan I, Orbinski J, Attaran A, Singh S,
et al. Adherence to antiretroviral therapy in sub‑Saharan Africa
and North America: A meta‑analysis. JAMA 2006;296:679‑90.
6. Gordon LL, Gharibian D, Chong K, Chun H. Comparison of HIV
virologic failure rates between patients with variable adherence
to three antiretroviral regimen types. AIDS Patient Care STDS
2015;29:384‑8.
7. Morowatisharifabad MA, Movahed E, Farokhzadian J, Nikooie R,Hosseinzadeh M, Askarishahi M, et al. Antiretroviral therapy
adherence and its determinant factors among people living with
HIV/AIDS: A case study in Iran. BMC Res Notes 2019;12:162.
8. Agustin DA, Prasetyo AA, Murti B. A path analysis on
adherence to antiretroviral therapy among HIV/AIDS patients
at Dr. Moewardi hospital, Surakarta using health belief model.
J Health Promot Behav 2018;3:48‑55.
9. Pence BW, Miller WC, Gaynes BN, Eron JJ Jr. Psychiatric
illness and virologic response in patients initiating highly
active antiretroviral therapy. J Acquir Immune Defic Syndr
2007;44:159‑66.
10. Ferrari AJ, Charlson FJ, Norman RE, Patten SB, Freedman G,
Murray CJ. Burden of depressive disorders by country, sex, age,
and year: Findings from the global burden of disease study 2010.
PLoS Med 2013;10:e1001547.
11. Lund C, De SilvaM, Plagerson S, Cooper S, Chisholm D, Das J, et al.
Poverty and mental disorders: Breaking the cycle in low‑income
and middle‑income countries. Lancet 2011;378:1502‑14.
12. Weiser SD, Riley ED, Ragland K, Hammer G, Clark R,
Bangsberg DR, et al. Brief report: Factors associated with
depression among homeless and marginally housed HIV‑infected
men in San Francisco. J Gen Intern Med 2006;21:61‑4.
13. Amini Lari M, Parsa N, Marzban M, Shams M, Faramarzi H.
Depression, testosterone concentration, sexual dysfunction
and methadone use among men with hypogonadism and HIV
infection. AIDS Behav 2012;16:2236‑43.
14. Alexander DS, Hogan SL, Jordan JM, DeVellis RF, Carpenter DM.
Examining whether the information‑motivation‑behavioral skills
model predicts medication adherence for patients with a rare
disease. Patient Prefer Adherence 2017;11:75‑83.
15. Fisher JD, Fisher WA, Shuper P A . T h e
information‑motivation‑behavioral skills model of HIV
preventive behavior. Emerging Theories in Health Promotion
Practice and Research. San Francisco, CA: Jossey‑Bass; 2009.
p. 21‑63.
16. Starks TJ, Millar BM, Lassiter JM, Parsons JT. Preintervention
profiles of information, motivational, and behavioral self‑efficacy
for methamphetamine use and HIV medication adherence
among gay and bisexual men. AIDS Patient Care STDS
2017;31:78‑86.
17. Kanmogne GD, Qiu F, Ntone FE, Fonsah JY, Njamnshi DM,
Kuate CT, et al. Depressive symptoms in HIV‑infected and
seronegative control subjects in Cameroon: Effect of age,
education and gender. PLoS One 2017;12:e0171956.
18. Zhang H, Liao M, Nie X, Pan R, Wang C, Ruan S, et al.
Predictors of consistent condom use based on the
information‑motivation‑behavioral skills (IMB) model among
female sex workers in Jinan, China. BMC Public Health
2011;11:113.
19. Barclay TR, Hinkin CH, Castellon SA, Mason KI, Reinhard MJ,
Marion SD, et al. Age‑associated predictors of medication
adherence in HIV‑positive adults: Health beliefs, self‑efficacy,
and neurocognitive status. Health Psychol 2007;26:40‑9.
20. Lee G, Yang SJ, Chee YK. Assessment of healthy behaviors
for metabolic syndrome among Korean adults: A modified
information‑motivation‑behavioral skills with psychological
distress. BMC Public Health 2016;16:518.
21. Chang SJ, Choi S, Kim SA, Song M. Intervention strategies based
on information‑motivation‑behavioral skills model for health
behavior change: A systematic review. Asian Nurs Res (Korean
Soc Nurs Sci) 2014;8:172‑81.
22. Norton WE, Amico KR, Fisher WA, Shuper PA, Ferrer RA,
Cornman DH, et al. Information‑motivation‑behavioral skills
barriers associated with intentional versus unintentional ARV
non‑adherence behavior among HIV+patients in clinical care.
AIDS Care 2010;22:979‑87.
23. Rongkavilit C, Naar‑King S, Kaljee LM, Panthong A,
Koken JA, Bunupuradah T, e t al. A p p l y i n g t h e
information‑motivation‑behavioral skills model in medication
adherence among Thai youth living with HIV: A qualitative study.
AIDS Patient Care STDS 2010;24:787‑94.
24. Egede LE, Osborn CY. Role of motivation in the relationship
between depression, self‑care, and glycemic control in adults
with type 2 diabetes. Diabetes Educ 2010;36:276‑83.
25. Coleman CL. Health related quality of life and depressive
symptoms among seropositive African Americans. Appl Nurs
Res 2017;33:138‑41.
26. Prasithsirikul W, Chongthawonsatid S, Ohata PJ, Keadpudsa S,
Klinbuayaem V, Rerksirikul P, et al. Depression and anxiety were
low amongst virally suppressed, long‑term treated HIV‑infected
individuals enrolled in a public sector antiretroviral program in
Thailand. AIDS Care 2017;29:299‑305.
27. Fonsah JY, Njamnshi AK, Kouanfack C, Qiu F, Njamnshi DM,
Tagny CT, et al. Adherence to antiretroviral therapy (ART)
in Yaoundé‑Cameroon: Association with opportunistic
infections, depression, ART regimen and side effects. PLoS One
2017;12:e0170893.
28. Kim J, Lee E, Park BJ, Bang JH, Lee JY. Adherence to antiretroviral
therapy and factors affecting low medication adherence
among incident HIV‑infected individuals during 2009‑2016:
A nationwide study. Sci Rep 2018;8:3133.
29. Banagi YA, Unnikrishnan B, Ramapuram JT, Kumar N, Mithra P,
Kulkarni V, et al. Factors influencing adherence to antiretroviral
therapy among people living with HIV in Coastal South India.
J Int Assoc Provid AIDS Care 2016;15:529‑33.
30. Oskouie F, Kashefi F, Rafii F, Gouya MM, Vahid‑Dastjerdi M.
Facilitating factors of self‑care among HIV‑positive young women
in Iran: A qualitative study. Int J Adolesc Med Health 2018. pii:/j/
ijamh.ahead‑of‑print/ijamh‑2017‑0172/ijamh‑2017‑0172.xml.
31. Mukui IN, Ng’ang’a L, Williamson J, Wamicwe JN, Vakil S,
Katana A, et al. Rates and predictors of non‑adherence to
antiretroviral therapy among HIV‑positive individuals in Kenya:
Results from the second Kenya AIDS indicator survey, 2012. PLoS
One 2016;11:e0167465.
)