Preintervention Profiles of Information, Motivational, and Behavioral Self-Efficacy for Methamphetamine Use and HIV Medication Adherence Among Gay and Bisexual Men

Although rates of crystal methamphetamine use in the United States have fallen from their peak in the mid-2000s, use remains a major public health concern, which disproportionately affects gay and bisexual men (GBM). It poses a particular challenge for HIV-positive men, for whom it has been linked to medication adherence problems as well as compromised immune function. Although the information, motivation, and behavioral skills (IMB) model has been widely used to conceptualize health behavior, little is known about GBM's initial levels of information, motivation, and behavioral self-efficacy to improve HIV medication adherence and to reduce crystal methamphetamine use at the outset of treatment. The present study identified profiles of IMB factors related to HIV medication adherence and crystal methamphetamine use in a sample of 210 HIV-positive GBM who consented to participate in an intervention study. Results indicated three distinct patterns of IMB factors. The largest group was ready to change both adherence and methamphetamine use (n = 104). This group also had depression scores that were significantly lower than other groups. A second group appeared ready to change medication adherence, but was ambivalent about changing methamphetamine use (n = 60). This group reported significantly more symptoms of methamphetamine dependence than the other groups. A third group was characterized by global IMB barriers to change (n = 46). Results are discussed in the context of tailoring psychoeducation, motivational interviewing, and cognitive behavioral interventions to match these preintervention patterns of IMB factors.