Assessing the Information-Motivation-Behavioral Skills Model to Predict Pre-exposure Prophylaxis Adherence Among Black Men Who have Sex with Men and Transgender Women in a Community Setting in New York City

Justin Knox; Bryan A Kutner; Stephanie Shiau; Frieda Sara Winterhalter; Yingfeng Wu; Yael Hirsch-Moverman; Wafaa El-Sadr; Paul W Colson; Julie Franks

doi:10.1007/s10461-022-03588-7

Assessing the Information-Motivation-Behavioral Skills Model to Predict Pre-exposure Prophylaxis Adherence Among Black Men Who have Sex with Men and Transgender Women in a Community Setting in New York City

AIDS Behav. 2022 Jul;26(7):2494-2502. doi: 10.1007/s10461-022-03588-7. Epub 2022 Jan 30.

Authors

Justin Knox^{1

2}, Bryan A Kutner^{3

4}, Stephanie Shiau⁵, Frieda Sara Winterhalter⁶, Yingfeng Wu⁶, Yael Hirsch-Moverman^{6

7}, Wafaa El-Sadr^{6

7}, Paul W Colson⁶, Julie Franks^{6

8}

Affiliations

¹ Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY, 10032, USA. jrk2115@columbia.edu.
² HIV Center for Clinical and Behavioral Studies, NYS Psychiatric Institute and Columbia University, New York, NY, USA. jrk2115@columbia.edu.
³ Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY, 10032, USA.
⁴ HIV Center for Clinical and Behavioral Studies, NYS Psychiatric Institute and Columbia University, New York, NY, USA.
⁵ Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.
⁶ ICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, USA.
⁷ Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA.
⁸ Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, USA.

Abstract
in English, Spanish

The Information-Motivation-Behavioral Skills (IMB) Model has been used to understand adherence to medications and intentions to uptake pre-exposure prophylaxis (PrEP) to prevent HIV infection. In the current study, the IMB Model was used to understand factors that predict adherence to PrEP among a community-based cohort of 204 Black men who have sex with men (MSM) and transgender women (TGW) using structural equation modeling. PrEP motivation was directly associated with PrEP behavioral skills (β = 0.320, p = 0.009), and PrEP behavioral skills were directly associated with PrEP adherence (β = 0.416, p = 0.001). PrEP knowledge and PrEP motivation were not associated with PrEP adherence, directly or indirectly. The analysis identified intervenable factors that predicted PrEP adherence. Screening for motivation and behavioral skills could be used to identify where additional support to improve PrEP adherence is needed, or whether to offer alternative PrEP modalities or delivery strategies.

El Modelo de Información-Motivación-Habilidades Conductuales (IMB) ha sido utilizado para comprender la adherencia a los medicamentos y la intención de tomar la profilaxis pre-exposición (PrEP) para prevenir la infección por el VIH. En el estudio actual, se usó el modelo IMB para comprender los factores que predicen la adherencia a la PrEP entre una cohorte reclutada en la comunidad de 204 hombres que tienen sexo con hombres (HSH) y mujeres transgénero (TGW) de raza negra, usando modelos de ecuaciones estructurales. La motivación de adherir a la PrEP se asoció directamente con las habilidades conductuales de la PrEP adherencia (β = 0.320, p = 0.009), y las habilidades conductuales de la PrEP adherencia se asociaron directamente con la adherencia a la PrEP (β = 0.416, p = 0.001). El conocimiento de PrEP y la motivación de adherir a la PrEPno se asociaron con la adherencia a la PrEP, ni directa o indirectamente. El análisis identificó factores intervenibles que predijeron la adherencia a la PrEP. La evaluación de la motivación de adherir a la PrEP y las habilidades conductuales de la PrEP adherencia podría ser usado para identificar situaciones en que se necesita apoyo adicional para mejorar la adherencia a la PrEP, o si se deben ofrecer modalidades alternativas de recibir PrEP o estrategias alternativas para entregar PrEP.

Keywords: Adherence; HIV; Information–motivation–behavioral skills (IMB) model; Men who have sex with men (MSM); Pre-exposure prophylaxis (PrEP); Transgender women (TGW).

MeSH terms

Anti-HIV Agents* / therapeutic use
Female
HIV Infections* / drug therapy
HIV Infections* / prevention & control
Homosexuality, Male
Humans
Male
Motivation
New York City / epidemiology
Pre-Exposure Prophylaxis*
Sexual and Gender Minorities*
Transgender Persons*

Substances

Anti-HIV Agents

Abstract in English, Spanish

MeSH terms

Substances

Grants and funding

Abstract
in English, Spanish