Adherence to combination antiretroviral therapies in HIV patients of low health literacy.
OBJECTIVE
To test the significance of health literacy relative to other predictors of adherence to treatment for HIV and AIDS.


METHODS
Community sample of HIV-seropositive men (n = 138) and women (n = 44) currently taking a triple-drug combination of antiretroviral therapies for HIV infection; 60% were ethnic minorities, and 73% had been diagnosed with AIDS.


METHODS
An adapted form of the Test of Health Literacy in Adults (TOFHLA), a comprehensive health and treatment interview that included 2-day recall of treatment adherence and reasons for nonadherence, and measures of substance abuse, social support, emotional distress, and attitudes toward primary care providers.


RESULTS
Multiple logistic regression showed that education and health literacy were significant and independent predictors of 2-day treatment adherence after controlling for age, ethnicity, income, HIV symptoms, substance abuse, social support, emotional distress, and attitudes toward primary care providers. Persons of low literacy were more likely to miss treatment doses because of confusion, depression, and desire to cleanse their body than were participants with higher health literacy.


CONCLUSIONS
Interventions are needed to help persons of low literacy adhere to antiretroviral therapies.
Kalichman
S C
SC
Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee 53226, USA.
Ramachandran
B
B
Catz
S
S
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D016001:Confidence Intervals; D003625:Data Collection; D004359:Drug Therapy, Combination; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D012494:Sampling Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States
D019380:Anti-HIV Agents