361P
THE ANTIRETROVIRAL READINESS AND MOTIVATION SCALE (ARMS): VALIDATION OF A NEW MEASURE OF READINESS FOR ADHERENCE TO ANTIRETROVIRAL THERAPY
J Geller1, V Alfonso1, A Toulson1, N Bermbach1, C Alexander2, K Heath2, W Piper3, JS Montaner1
¹Pacific Region, Canadian HIV Clinical Trials Network; 2BC Centre for Excellence in HIV/AIDS; 3Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
Objectives: HAART offers individuals the potential to live longer, healthier lives. However, adhering to HAART is a complex and demanding process. Almost perfect adherence (>95%) is needed to achieve successful clinical outcomes (ie, suppressed viral load) and sub-optimal adherence can result in drug resistance and limit future treatment options. Having a means of assessing patient readiness to take HAART and to determine which psychological variables are most closely connected to adherence would enable treatment providers to identify patients not ready for treatment and to provide them with appropriate preparatory interventions to increase readiness. To date, no comprehensive readiness assessment tool has been developed. The purpose of this project is to develop a psychometrically sound measure of readiness for adherence to HAART.
Methods: The ARMS is a 42-item questionnaire consisting of seven subscales, each reflecting a domain previously shown to be associated with adherence. ARMS subscales include: support, barriers/self-efficacy, depression, outcome expectancies, drug and alcohol use, readiness and personal strengths. The ARMS was administered to two groups of patients: those who were currently taking antiretroviral medications (n = 52) and those who were starting antiretroviral medications (n = 33).
Results: Test-retest analyses indicated that ARMS sub-scale scores were stable over a one-month period. In addition, ARMS support and depression sub-scales were significantly correlated with previously established measures of these constructs (Duke Social Support Scale, Brief Symptom Inventory, respectively). There were significant associations among ARMS sub-scales suggesting overlap between readiness domains.
Conclusions: Ongoing evaluations provide evidence of the reliability, stability, and concurrent and construct validity of the ARMS. Longitudinal evaluation of the ARMS is currently underway; future analysis will examine the ability of the ARMS to predict adherence and viral load at six month follow-up.