title: Neurocognition, health-related reading literacy, and numeracy in medication management for HIV infection.
abstract: Successful medication management is an essential ingredient for effective treatment for HIV. Risk factors for poor medication adherence, including neurocognitive impairment and low health literacy, are common in HIV patients. To better understand the most salient risks for poor management of HIV medications, we tested the interrelation of neurocognitive functioning, reading literacy for health related information, and numeracy and their effect on self-management of a simulated HIV medication regimen. Cross-sectional data on 191 HIV-positive men and women recruited from HIV outpatient clinics in South Florida were collected. Exploratory factor analysis was conducted with literacy, numeracy, and neurocognitive scores and suggested that four factors were present representing executive skill, verbal memory, planning, and motor speed. Both the literacy and numeracy scores loaded on the executive factor. Adjusted analyses showed that executive and planning skills were significantly related to medication management. Findings suggest that patients must rely on higher order cognitive skills to successfully navigate medication self-management, and that efforts to simplify health information that merely lowers readability are likely to meet with limited success.
authors.affiliation: Department of Psychiatry & Behavioral Sciences, University of Miami, Miller School of Medicine, Miami, Florida 33136, USA. DWaldrop@med.miami.edu
authors.forename: Drenna
authors.initials: D
authors.lastname: Waldrop-Valverde
authors.forename: Deborah Lynne
authors.initials: DL
authors.lastname: Jones
authors.forename: Felicia
authors.initials: F
authors.lastname: Gould
authors.forename: Mahendra
authors.initials: M
authors.lastname: Kumar
authors.forename: Raymond L
authors.initials: RL
authors.lastname: Ownby
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D005431:Florida; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D057220:Health Literacy; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009483:Neuropsychological Tests; D010353:Patient Education as Topic; D011932:Reading; D012648:Self Care / Q000523:psychology
chemical_list: D019380:Anti-HIV Agents