Health Literacy and Adherence to Antiretroviral Therapy Among HIV-Infected Youth

Abstract

Health literacy has been associated with adherence to antiretroviral therapy (ART) in HIV-infected adults, but this association has not been demonstrated in HIV-infected adolescents. Using an expanded health literacy model, we examined the relationship between health literacy, functional literacy, beliefs about ART, media use, and adherence to ART. A convenience sample of HIV-infected adolescents (n = 50) was recruited for this cross sectional study. The primary outcome of adherence was measured with 3-day self-reports. Health literacy as measured by the Test of Functional Health Literacy in Adults (TOFHLA) was not predictive of adherence (p = .15). Participants with higher positive outcome expectancy scores regarding ART were more likely to report 100% adherence, and participants with below grade level reading were less likely to report 100% adherence (p < .05). Our findings highlight the importance of assessing both health beliefs and reading skills as part of adherence support for HIV-infected youth.

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

“…Besides, they have been recently found to show deficient knowledge of their HIV-related health status, 68 low compliance with clinical prescription, 66 inadequate treatment awareness, 69 and poor medication adherence. 70 From this point of view, it is argued that people living with HIV and limited health literacy skills are expected to report lower health conditions as well as greater number of hospitalizations compared to their health literate counterparts. 67 This assumption is of particular interest, since the hospital setting paves the way for increased risks of inappropriateness dealing with long term conditions in general, and HIV infection in particular.…”

Health Literacy in Adolescents With Sickle Cell Disease

“…On the contrary, confidence with medications and side effects of inflammatory bowel disease (IBS) medications is not significantly associated with gender, nor is self-reported medication adherence in HIV infected youth (Fishman et al, 2010;Navarra et al, 2013). In addition, a study looking at sexual reproduction knowledge amongst Cystic Fibrosis patients…”

“…In HIV-positive youth, participants with below-grade-level reading are less likely to report 100% medication adherence to antiretroviral therapy (p <.05) (Murphy et al, 2010;Navarra et al, 2013). In addition, less than average reading skill leads to two and half times the risk of teen childbearing than average reading skill and above average reading skill is associated with less risk of teen pregnancy (Bennett, Frasso, Bellamy, Wortham, & Gross, 2013).…”

“…Functional literacy did not predict health literacy (i.e., even those with low functional literacy had high health literacy). The authors attribute this to the participants' frequent exposure to the health care system, health care professionals, and recurrent medical encounters throughout their lifetimes (Navarra et al, 2013). In addition, an adult HIV study shows that the majority of patients identified four primary sources of health information, with two-thirds of participants reporting their doctor as their primary source of information on the medical aspects of their care (Zukoski, Thorburn, & Stroud, 2011).…”

“…The literature shows that increasing age is associated with increased health literacy in adolescents with asthma and diabetes (Chisolm, Hardin, et al, 2011;Yang et al, 2012). However, other studies show no significant difference in age groups with health literacy scores and treatment adherence in adolescent patients with HIV, congenital heart disease, inflammatory bowel syndrome (IBS), diabetes, and asthma Fishman et al, 2010;Lok & Menahem, 2012;Navarra et al, 2013). In the Fishman et al (2010) article, the relationship between age and increased knowledge and confidence showed a trend similar to what was found in this study; but it was not statistically significant.…”