Association Between Health Literacy and HIV Treatment Adherence: Further Evidence from Objectively Measured Medication Adherence

Abstract

Background People with lower health literacy are vulnerable to health problems. Studies that have examined the association between literacy and medication adherence have relied on self-reported adherence, which is subject to memory errors, perhaps even more so in people with poor literacy. Purpose To examine the association between health literacy and objectively assessed HIV treatment adherence. Methods Men and women (N = 145) receiving antiretroviral therapies completed a test of health literacy and measures of common adherence markers. Medication adherence was monitored by unannounced pill counts. Results Median adherence was 71%; Participants with lower health literacy also demonstrated poorer adherence compared to individuals with higher literacy. Hierarchical regression showed literacy predicted adherence over and above all other factors. Sensitivity tests showed the same results for 80% and 90% adherence. Conclusions The association between literacy and adherence appears robust and was confirmed using an objective measure of medication adherence.

Health literacy for people living with HIV/Aids: an integrative review

“…This is justified by the fact that health literacy is a subjective aspect of the human being, which is more convenient to evaluate by such studies. However, there are few studies on health literacy in the context of people living with HIV/Aids, a fact evidenced by this research, (24) . (25) .…”

“…In addition, the use of educational technologies is a current trend that improves patients' knowledge about the Health literacy for people living with HIV/Aids: an integrative review Cunha GH, et al conduct of the treatment, but should be used with caution, especially considering the patient access to different types of existing technologies (15)(16)(17)(18) . It is also noteworthy that in areas of extreme poverty, a larger number of behavioral and clinical educational interventions is required to achieve and maintain optimal levels of adherence, and virologic suppression successful long-term treatment (15,(23)(24)(25) .…”

“…Considering economically disadvantaged populations living with HIV/Aids, it is emphasized that cognitive and behavioral approaches facilitate adherence to antiretroviral drugs and may have a long term beneficial effect (8,(23)(24)(29)(30) . Thus, it is clear that health education is extremely important in populations with HIV/Aids.…”

Health Literacy in Adolescents With Sickle Cell Disease

“…As discussed, the literature shows that SCD patients' ability to find, understand and utilize health information may be diminished before and after transition; and, when health literacy is low, poor health outcomes follow (Kalichman et al, 2008;Kutner et al, 2006).…”

Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review

“…421 In fact, a cross-sectional study aimed at examining the association between health literacy and objectively assessed HIV treatment adherence found the relation between these two dimensions to be robust, with health literacy predicting adherence over and above all other factors. 75 As well, through multivariate regression models examining the associations among race, literacy, and HIV-medication adherence in a convenience sample of HIV infected patients recruited from two different clinics, Osborn and colleagues 76 found that health literacy mediated the relationship between race and poor HIV-medication adherence, performing as a significant independent predictor of nonadherence. Waldrop-Valverde et al 77 expanded these findings, suggesting that health literacy skills -especially functional ones -mediated the impacts of gender on the appropriate medication management of HIV.…”