The predictive relationship of drug-abstinence self-efficacy, health locus of control, drug use severity, and HIV illness severity on readiness to change drug use among out-of-treatment HIV+ drug users

Substance abuse and HIV are inextricably related public health problems. Many drug users living with HIV do not readily change their drug use behavior or access treatment services, putting themselves at further risk for health problems and infecting others with HIV. This study investigated the predictive strength, quality, and nature of health locus of control (HLoC), drug abstinence self-efficacy, drug use severity, and HIV severity on readiness to change drug use among out-of-treatment HIV-positive (HIV+) drug-users. The transtheoretical model of behavior change served as the theoretical foundation. Data were obtained from 165 participants from three southern states. Data were analyzed using Pearson correlations, multiple regression, and analysis of variance. Pearson correlations revealed significant positive relationships between internal HLoC, drug use severity, and readiness to change and significant negative relationships between drug abstinence self-efficacy, HIV severity, and readiness to change drug use. Forward multiple regression analyses indicated that higher internal HLoC, lower drug abstinence self-efficacy, and higher HIV severity predicted 14.9% of the variance in readiness to change drug use behavior. Drug use severity significantly moderated the relationship between self-efficacy and readiness to change drug use. Follow-up analyses revealed African American participants scored significantly higher than White participants on readiness to change drug use. More research is needed among this population to decrease the adverse consequences of drug abuse on health care delivery systems, legal systems, overall economy, and transmission of HIV in order to effect social change and improve the quality of lives of individuals, families, and communities.