Health-Related Everyday Functioning in the Internet Age: HIV-Associated Neurocognitive Disorders Disrupt Online Pharmacy and Health Chart Navigation Skills

Abstract

This study evaluated the effects of HIV-associated Neurocognitive Disorders (HAND) on 2 Internet-based tests of healthcare management. Study participants included 46 individuals with HIV infection, 19 of whom were diagnosed with HAND, and 21 seronegatives. Participants were administered Internet-based tests of online pharmacy and health records navigation skills in which they used mock credentials to log in to an experimenter-controlled website and independently perform a series of typical online health-related behaviors (e.g., refill a prescription, read and interpret an electronic chart note). HAND was associated with significantly lower accuracy on both the online pharmacy and health records navigation tasks. Among the HIV+ participants, poorer performance on the online healthcare navigation tasks was associated with fewer years of education, higher plasma viral load, less frequent Internet use, and lower health literacy. Findings indicate that individuals with HAND may have marked difficulties navigating the Internet to complete important health-related behaviors.

eHealth Literacy in People Living with HIV: Systematic Review (Preprint)

“…Although one RCT scored 8 of 13 [23] and one of three quasi-experimental studies scored 6 of 9, [24] they had strengthened validity of causal inferences by comparing control and intervention groups. In addition, two quasi-experimental studies scored 6 of 9 [25,26] and lacked a comparison group to determine pre-post intervention effects.…”

“…Four studies were conducted in the U.S., [24][25][26][27] two in Uganda, [23,28] and one in Peru. [29] Various study designs were used: cross-sectional, [27][28][29] quasi-experimental, [24][25][26] and a RCT. [23] Two studies identified a theoretical or conceptual framework used in their research.…”

“…[23,25] Study participants were recruited from a variety of settings: community-based HIV/AIDS organizations, [25,[27][28][29] HIV hospital settings, [23,26] and both community-based and hospital settings. [24] Overall, HIV-infected adults older than 18 years were included; one study included only people who had advanced immunosuppression (CD4+ T cell count < 350 cells/mm 3 and taking ARTs for at least four years), [28] one included women only, [27] and one involved men who have sex with men (MSM) and/or transgender women (TGW). [29] The sample sizes ranged from 18 to 895.…”

“…Among studies that included women, most had a majority of female participants (56-100%), but two [24][25][26] included only 9% and 29% of females, respectively. Studies in the U.S.…”

“…tended to include a large proportion of African American or Black (57-63%) participants [24][25][26][27] in which more than half (54.3%) of the study sample was Caucasian. All but one study [29] reported low educational levels, with 37-65% of participants having less than a high school education.…”