title: Measuring Health Literacy Among Adults with HIV Infection in Mozambique: Development and Validation of the HIV Literacy Test.
abstract: The role of health literacy on HIV outcomes has not been evaluated widely in Africa, in part because few appropriate literacy measures exist. We developed a 16-item scale, the HIV Literacy Test (HIV-LT) to assess literacy-related tasks needed to participate in HIV care. Items were scored as correct or incorrect; higher scores indicated higher literacy skill (range 0-100 %). We tested internal reliability (Kuder-Richardson coefficient) of the HIV-LT in a convenience sample of 319 Portuguese-speaking, HIV infected adults on antiretroviral treatment in Maputo, Mozambique. Construct validity was assessed by a hypothetical model developed a priori. The HIV-LT was reliable and valid to measure participants' literacy skills. The mean HIV-LT score was 42 %; literacy skills applicable to HIV care were challenging for many participants. The HIV-LT could be used to assess the relationship of literacy and HIV-related outcomes in diverse settings, and evaluate interventions to improve health communication for those in HIV care.
authors.affiliation: National STI's and HIV Program, Ministry of Health, Avenida Eduardo Mondlane/Salvador Allende, Maputo, Mozambique. jose.tique@fgh.org.mz.
authors.forename: José A
authors.identifier: http://orcid.org/0000-0003-4156-1069
authors.initials: JA
authors.lastname: Tique
authors.affiliation: Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, USA.
authors.forename: Leigh M
authors.initials: LM
authors.lastname: Howard
authors.affiliation: Community Health Department, Eduardo Mondlane University, Maputo, Mozambique.
authors.forename: Sandra
authors.initials: S
authors.lastname: Gaveta
authors.affiliation: Community Health Department, Eduardo Mondlane University, Maputo, Mozambique.
authors.forename: Mohsin
authors.initials: M
authors.lastname: Sidat
authors.affiliation: Departments of Pediatrics and Medicine, Vanderbilt University School of Medicine, Nashville, USA.
authors.forename: Russell L
authors.initials: RL
authors.lastname: Rothman
authors.affiliation: Departments of Pediatrics and Medicine, Vanderbilt University School of Medicine, Nashville, USA.
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
authors.affiliation: Harvard Medical School, Harvard University, Boston, USA.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Ciampa
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy; D058015:Health Communication; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009073:Mozambique; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Antiretroviral therapy; HIV; Health communications; Health literacy; Mozambique; Poverty; Psychometrics