Adaptation of the Information-Motivation-Behavioral Skills Model to Needle Sharing Behaviors and Hepatitis C Risk: A Structural Equation Model

The current study adapts the Information-Motivation-Behavioral Skills (IMB) model of health behavior to injection drug using risk behaviors and risk for Hepatitis C (HCV). Briefly, this model postulates that prevention behaviors are directly influenced by an individual's knowledge about a disease, their motivation to avoid the disease and their skills and capacity to engage in prevention behaviors, while information and motivation also directly influence behavioral skills. Scales for HCV information, motivation and behavioral skills were included in the New Orleans arm of the National HIV Behavioral Surveillance (NHBS) of Injection Drug Use study. A structural equation model was tested on a sample of 108 current injection drug users recruited in December 2012. Results showed good fit of the IMB model. Although participants had high levels of information and knowledge about HCV transmission, information was not found to relate to either behavioral skills or needle sharing. Higher levels of skills were directly related to lower levels of needle sharing. In addition, motivation had an indirect effect on needle sharing that was mediated through skills. Many approaches to HIV and HCV prevention focus on increasing awareness and information about HIV and risk behaviors. This model, however, appears to indicate that increasing awareness may not be as effective as interventions or programs that increase behavioral skills or motivation coupled with skills building. Although some HIV/STD prevention interventions, such as motivational interviews do attempt to capitalize on this relationship, more efforts should be made to incorporate this important link into high impact prevention programs.