Self-reevaluation as a critical component in sustained viral load change for HIV+ adults with alcohol problems

Abstract

Self-reevaluation is one of the ten processes of change in the transtheoretical model and involves cognitive reappraisal of how behavior change is part of one's identity. Although self-reevaluation is a critical motivator for individuals in the contemplation stage of change, few studies have examined its impact on disease progression associated with sustained behavior change. This study investigated the contribution of self-reevaluation on sustained viral load improvement among 143 participants in a randomized controlled trial testing an eight-session intervention (Project Positive Living through Understanding and Support) designed to improve treatment adherence among HIV+ adults with alcohol problems. Participants' self-reevaluation scores at 3 months emerged as significant and independent predictors of sustained improvement in viral load at 6 months, over and above self-reported HAART dose adherence (p<0.05). Results underscore the role of self-reevaluation as a critical factor in behavioral interventions and highlight its role in sustained change necessary to slow disease progression. © 2010 The Society of Behavioral Medicine.