Motivational Interviewing: HIV-Related Health Outcomes and Social Determinants of Health

For individuals experiencing housing insecurity—and other hardships associated with poverty, such as low rates of health literacy, food insecurity, lack of transportation, and restricted access to quality health care—an HIV diagnosis exacerbates an already burdened quality of life. These larger structural barriers may inhibit HIV+ participants from feeling able to change individual-level behaviors which may complicate their HIV status. One counseling intervention that addresses obstacles to change is Motivational Interviewing (MI). MI is a collaborative, client centered approach that fosters communication between a service provider and their recipient with the goal of identifying and resolving the change goals identified during the counseling session. Studies on healthcare outcomes for chronically ill individuals who received MI interventions indicate that, when followed properly, MI can effect long-term, positive behavior changes. This paper defines MI, explores it's applications among HIV+ participants, describes an MI fidelity monitoring tool, and situates MI relevance while acknowledging the influence of social determinants of health.