HIV remains a major public health issue, despite advances in highly active antiretroviral therapy (HAART) to prevent viral replication. Strict adherence to HAART is necessary for achieving effects, as insufficient HAART adherence has been associated with increases in HIV viral load, the development of drug resistant strains of HIV and increased mortality. New guidelines for the prescription of HAART recommend initiating HAART earlier, but factors such as drug use and depression are associated with poor adherence. Validated methods for improving HAART adherence are needed. The Information-Motivation-Behavioral Skills (IMB) model of behavior change, which has been validated in other applications, has recently been applied to antiretroviral adherence, demonstrating efficacy in early studies (Fisher &Fisher, 2006). According to the IMB model of behavior change, information about the medication regimen alone is insufficient for behavior change. Motivation and behavioral skills regarding adherence must also be enhanced as well. IMB-based interventions have shown promise with non-drug using populations, but the model has not been extended to work with a population that is actively using a variety of illicit drugs and can benefit considerably from improved adherence interventions. This project will (1) examine the acceptability and feasibility of an IMB intervention with active drug using HIV-positive individuals demonstrating poor HAART adherence, (2) estimate the effect size of an IMB intervention with active drug using HIV-positive individuals demonstrating poor HAART adherence, and (3) assess client satisfaction with an IMB intervention.

Public Health Relevance

HIV remains a public health issue. Strict adherence to highly active antiretroviral therapy (HAART) is necessary and adherence-improving interventions are needed for active drug users. The Information-Motivation-Behavioral Skills (IMB) model of behavior change is a promising method of improving HAART adherence, but needs further examination to determine its efficacy in active drug users.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Postdoctoral Individual National Research Service Award (F32)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-AARR-J (22))
Program Officer
Kahana, Shoshana Y
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of California San Francisco
Schools of Medicine
San Francisco
United States
Zip Code
Newville, Howard; Berg, Karina M; Gonzalez, Jeffrey S (2015) The interaction of active substance use, depression, and antiretroviral adherence in methadone maintenance. Int J Behav Med 22:214-22
Newville, Howard; Roley, Jason; Sorensen, James L (2015) Prescription medication misuse among HIV-infected individuals taking antiretroviral therapy. J Subst Abuse Treat 48:56-61
Newville, Howard; Sorensen, James L (2013) The efficacy of a computerized assessment of medication adherence in active substance users. J Int Assoc Provid AIDS Care 12:232-5
Manuel, Jennifer K; Newville, Howard; Larios, Sandra E et al. (2013) Confidentiality protections versus collaborative care in the treatment of substance use disorders. Addict Sci Clin Pract 8:13