title: 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.
  
  
  OBJECTIVE
  To examine the association between health literacy and objectively assessed HIV treatment adherence.
  
  
  METHODS
  Men and women (N = 145) receiving antiretroviral therapy 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 participants 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.
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, Connecticut 06269, USA. seth.k@uconn.edu
authors.forename: Seth C
authors.initials: SC
authors.lastname: Kalichman
authors.forename: Howard
authors.initials: H
authors.lastname: Pope
authors.forename: Denise
authors.initials: D
authors.lastname: White
authors.forename: Chauncey
authors.initials: C
authors.lastname: Cherry
authors.forename: Christina M
authors.initials: CM
authors.lastname: Amaral
authors.forename: Connie
authors.initials: C
authors.lastname: Swetzes
authors.forename: Jody
authors.initials: J
authors.lastname: Flanagan
authors.forename: Moira O
authors.initials: MO
authors.lastname: Kalichman
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D004334:Drug Administration Schedule; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010349:Patient Compliance; D011795:Surveys and Questionnaires; D013689:Telephone; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents