HIV-positive people with low health-literacy levels are less likely to understand their medication instructions and, therefore, are less compliant with their antiretroviral treatment regimens, according to a study published in the November issue of the American Journal of Preventive Medicine, Reuters Health reports.
For the study, Chandra Osborn of Northwestern University and colleagues investigated the link between health literacy and racial disparities in the adherence to antiretroviral treatment among 204 HIV-positive people attending outpatient clinics in Chicago and Shreveport, La. Eighty percent of the participants were male, 45% were black and their average age was 40, Reuters Health reports. Overall, more than 70% of the participants were taking three or more antiretroviral drugs, and more than 50% were being treated for other illnesses, according to researchers.
The health-literacy levels were determined by the participants' overall literacy skills. Using a health-related word recognition test, the researchers found that 68.6% of the participants had adequate health literacy or were able to read at a ninth grade or higher level. More than 20% had marginal health literacy, reading at the seventh to eighth grade level, and about 11% had reading levels below that, the study found. After taking into account the effects of age, gender, income, number of medications and other diseases, researchers found that blacks were 2.4 times more likely to not be adhering to their treatment, compared with other groups, Osborn said. She added that when the effects of literacy were considered, "literacy was a significant predictor of nonadherence, such that patients with low literacy were 2.1 times more likely to be nonadherent to their medication regimen than patients with adequate literacy." The researchers noted that health literacy is a potentially amendable barrier to adherence (Hendry, Reuters Health, 11/15).
An abstract of the study is available online.
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