Motivational barriers to retention of at-risk young adults in HIV-prevention interventions: perceived pressure and efficacy

Abstract

Multi-session HIV-prevention interventions are efficacious but depend on the retention of clients over time. In a sample of at-risk young adults (N = 386), we investigated three potential motivational barriers that might affect the likelihood of retention. Perceived pressure, perceived efficacy and fear and anxiety during the initial session were measured, along with demographic characteristics, partner characteristics, and HIV-related health knowledge. Logistic regressions demonstrated that (1) in general, perceived ineffectiveness was negatively associated with retention; (2) perceived pressure or coercion was negatively associated with retention but only for younger clients; (3) experienced fear and anxiety had no significant association with retention. Implications for theory and counseling practices to reduce motivational barriers and effectively tailor interventions are discussed.

Keywords:

• HIV-prevention
• retention
• pressure
• ineffectiveness
• fear

Funding

This work was supported by National Institutes of Health [grant number R01 NR08325].

Notes

1. Although participants who earned $10,000–$19,999 per year were significantly more likely to return to the second session relative to those in the lowest income group, an omnibus test for income showed no significant overall effect of income on retention for either of the two models (p = .61–.62). This suggests an effect of income only at low levels of income with no evidence that increases in income above $20,000 increase the probability of return. Special effort to ensure retention may be useful with the poorest clients.

Additional information

Funding

Funding: This work was supported by National Institutes of Health [grant number R01 NR08325].