The Relationship between Change Talk during Motivational Interviewing and HIV Medication Adherence

Abstract

Although studies have demonstrated that change talk (CT) and sustain talk (ST) are related to behavior change in multiple addictive behaviors, few have investigated the relationship between change talk and outcome in health promotion. This is the first study to investigate whether CT and ST are related to HIV medication adherence in a sample of individuals recruited to participate in an ART adherence intervention. MI session tapes from 92 HIV-positive patients were coded for frequency of utterances expressing desire, ability, reasons, need, commitment, other, and taking steps to adhere/not adhere to an ART medication regimen. Strength of language as well as summary scores for both frequency and strength ratings were calculated. Adherence was assessed at Week 2 and Week 12. There was a significant relationship between Total ST and adherence at Week 2. Additionally, multiple regression with bootstrapped standard errors showed that Taking Steps ST was negatively related to adherence at both Week 2 and Week 12. Finally, Taking Steps Strength was related to adherence at Week 2 only. Findings from this study support the need for coding for individual change talk categories to determine what individual forms of change talk are related to health behaviors. The identification of Taking Steps ST as a predictor of poorer adherence suggests that Taking Steps ST might be an indicator of barriers to adhere to ART regimens.