Skip to main content

Advertisement

SpringerLink
Log in

Successful Aging is Associated with Better Health Literacy in Older Adults with HIV Disease

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

People with HIV (PWH) are susceptible to neurocognitive, physical, and mental health problems that may decrease their likelihood of experiencing successful aging. This cross-sectional, retrospective study estimated the extent to which health literacy is associated with successful aging among 116 older PWH and 60 persons without HIV. Successful aging was defined using indicators of biological health, cognitive efficiency, mental health, and productivity. Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine, Newest Vital Sign, Brief Health Literacy Screening, and Beliefs Related to Medication Adherence. A series of logistic regressions covarying for education showed that better health literacy was associated with a higher frequency of successful aging among older PWH. Older PWH were approximately three times less likely to experience successful aging as compared to older adults without HIV. Future studies may examine whether improving health literacy among younger PWH increases the likelihood of successful aging.

Resumen

Las personas que viven con VIH (PVVIH) son susceptibles de padecer problemas neurocognitivos, físicos y mentales que pueden reducir sus probabilidades de experimentar un envejecimiento exitoso. Este estudio transversal y retrospectivo estimó el grado en el que la alfabetización en salud está asociada con el envejecimiento exitoso entre 116 PVVIH mayores y 60 personas sin VIH. El envejecimiento exitoso se definió utilizando indicadores de salud biológica, eficiencia cognitiva, salud mental y productividad. La alfabetización en salud se midió mediante el Rapid Estimate of Adult Literacy in Medicine, Newest Vital Sign, Brief Health Literacy Screening y Beliefs Related to Medication Adherence. Una serie de regresiones logísticas con covarianza para la educación mostró que una mejor alfabetización en salud estaba asociada con una mayor frecuencia de envejecimiento exitoso entre las PVVIH mayores. Las personas mayores con VIH tenían aproximadamente tres veces menos probabilidades de experimentar envejecimiento exitoso en comparación con los adultos mayores sin VIH. Futuros estudios podrían examinar si la mejora de la alfabetización en salud entre las PVVIH más jóvenes aumenta la probabilidad de envejecimiento exitoso.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States, 2015–2019. HIV Surveill Suppl Rep. 2021; 26(1). http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. Accessed 15 Jan 2023.

  2. Horvath S, Lin DT, Kobor MS, Zoller JA, Said JW, Morgello S, et al. HIV, pathology and epigenetic age acceleration in different human tissues. GeroScience. 2022;44:1609–20. https://doi.org/10.1007/s13365-016-0483-y.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Sheppard DP, Iudicello JE, Morgan EE, Kamat R, Clark LR, Avci G, et al. Accelerated and accentuated neurocognitive aging in HIV infection. J Neurovirol. 2017;23:492–500. https://doi.org/10.1007/s13365-017-0523-2.

    Article  PubMed  PubMed Central  Google Scholar 

  4. GBD 2017 HIV collaborators. Global, regional, and national incidence, prevalence, and, mortality of HIV. 1980–2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study. Lancet HIV. 2019;6:831–59. https://doi.org/10.1016/S2352-3018(19)30196-1.

  5. Hakkers C, Arends J, Barth R, Du Plessis S, Hoepelman A, Vink M. Review of functional MRI in HIV: effects of aging and medication. J Neurovirol. 2017;23:20–32. https://doi.org/10.1007/s13365-016-0483-y.

    Article  CAS  PubMed  Google Scholar 

  6. Clifford DB, Ances BM. HIV-associated neurocognitive disorder. Lancet Infect Dis. 2013;13:976–86. https://doi.org/10.1016/S1473-3099(13)70269-X.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Wang Y, Liu M, Lu Q, Farrell M, Lappin JM, Shi J, et al. Global prevalence and burden of HIV-associated neurocognitive disorder: a meta-analysis. Neurology. 2020;95:e2610–21. https://doi.org/10.1212/WNL.0000000000010752.

    Article  CAS  PubMed  Google Scholar 

  8. Vance DE, Blake BJ, Brennan-Ing M, DeMarco RF, Fazeli PL, Relf MV. Revisiting successful aging with HIV through a revised biopsychosocial model: an update of the literature. J Assoc Nurses AIDS Care. 2019;30:5–14. https://doi.org/.

    Article  PubMed  Google Scholar 

  9. Mayo NE, Brouillette M-J, Nadeau L, Dendukuri N, Harris M, Smaill F, et al. A longitudinal view of successful aging with HIV: role of resilience and environmental factors. Qual Life Res. 2022;31:1135–45. https://doi.org/10.1007/s11136-021-02970-7.

    Article  PubMed  Google Scholar 

  10. Moore RC, Moore DJ, Thompson WK, Vahia IV, Grant I, Jeste DV. A case-controlled study of successful aging in older HIV-infected adults. J Clin Psychiatry. 2013;74(5):e417–23. https://doi.org/10.4088/JCP.12m08100.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Rubtsova AA, Wingood G, Ofotokun I, Mehta CC, Gustafson D, Vance DE, et al. Psychosocial mechanisms of self-rated successful aging with HIV: a structural equation model. AIDS Behav. 2021;25:2875–85. https://doi.org/10.1007/s10461-021-03340-7.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Sun-Suslow N, Pasipanodya E, Morgan E, Kohli M, Serrano V, Letendre S, et al. Social support moderates D-dimer and self-rated successful aging within people with HIV and older adults. J Behav Med. 2020;43:979–88. https://doi.org/10.1007/s10865-020-00141-6.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Malaspina L, Woods SP, Moore DJ, Depp C, Letendre SL, Jeste D, et al. Successful cognitive aging in persons living with HIV infection. J Neurovirol. 2011;17(1):110–9. https://doi.org/10.1007/s13365-010-0008-z.

    Article  PubMed  Google Scholar 

  14. Moore DJ, Fazeli PL, Moore RC, Woods SP, Letendre SL, Jeste DV, et al. Positive psychological factors are linked to successful cognitive aging among older persons living with HIV/AIDS. AIDS Behav. 2018;22:1551–61. https://doi.org/10.1007/s10461-017-2001-5.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Moore RC, Fazeli PL, Jeste DV, Moore DJ, Grant I, Woods SP, et al. Successful cognitive aging and health-related quality of life in younger and older adults infected with HIV. AIDS Behav. 2014;18:1186–97. https://doi.org/10.1007/s10461-014-0743-x.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Fazeli PL, Woods SP, Vance DE. Successful functional aging in middle-aged and older adults with HIV. AIDS Behav. 2020;24:1592–8. https://doi.org/10.1007/s10461-019-02635-0.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Capa L, Ayala-Suárez R, De La Torre Tarazona HE, González-García J, Del Romero J, Alcamí J, et al. Elite controllers long-term non progressors present improved survival and slower disease progression. Sci Rep. 2022;12(1):16356. https://doi.org/10.1038/s41598-022-19970-3.

    Article  ADS  CAS  PubMed  PubMed Central  Google Scholar 

  18. Emlet CA, Harris L. Giving back is receiving: the role of generativity in successful aging among HIV-positive older adults. J Aging Health. 2020;32:61–70. https://doi.org/10.1177/0898264318804.

    Article  PubMed  Google Scholar 

  19. Yoo-Jeong M, Nguyen AL, Waldrop D. Social network size and its relationship to domains of quality-of-life among older persons living with HIV. AIDS Care. 2023;35(4):600–7. https://doi.org/10.1080/09540121.2022.2057907.

    Article  PubMed  Google Scholar 

  20. Nguyen AL, Hussain MA, Pasipanodya E, Rubtsova AA, Moore RC, Jeste DV, et al. The impact of life stress, psychological resources, and proactive behaviors on quality of life among people living with HIV. Aging Ment Health. 2023;27(5):948–56. https://doi.org/10.1080/13607863.2022.2068126.

    Article  PubMed  Google Scholar 

  21. Berkman ND, Davis TC, McCormack L. Health literacy: what is it? J Health Commun. 2010;15:9–19. https://doi.org/10.1080/10810730.2010.499985.

    Article  PubMed  Google Scholar 

  22. Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80. https://doi.org/10.1186/1471-2458-12-80.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Matchanova A, Babicz M, Medina LD, Fazeli PL, Vance DE, Woods SP. Latent structure of health literacy and its association with health-related management and decision-making in HIV. Psychol Health. 2021;36:985–1002. https://doi.org/10.1080/08870446.2020.1817453.

    Article  PubMed  Google Scholar 

  24. Osborn CY, Davis TC, Bailey SC, Wolf MS. Health literacy in the context of HIV treatment: introducing the brief Estimate of Health Knowledge and Action (BEHKA)—HIV Version. AIDS Behav. 2010;14:181–8. https://doi.org/10.1007/s10461-008-9484-z.

    Article  PubMed  Google Scholar 

  25. Kalichman SC, Benotsch E, Suarez T, Catz S, Miller J, Rompa D. Health literacy and health-related knowledge among persons living with HIV/AIDS. Am J Prev Med. 2000;18(4):325–31. https://doi.org/10.1016/s0749-3797(00)00121-5.

    Article  CAS  PubMed  Google Scholar 

  26. Woods SP, Babicz MA, Matchanova A, Sullivan KL, Avci G, Hasbun R, et al. A clinical pilot study of spaced retrieval practice with a self-generation booster to improve health-related memory in persons with HIV disease. Arch Clin Neuropsychol. 2021;37(7):1296–306. https://doi.org/10.1093/arclin/acaa130.

    Article  Google Scholar 

  27. Beltran-Najera I, Woods SP, Evans D, Matchanova A, Mustafa A, Ridgely NC, Thompson JL, Gomez EM. Health literacy in HIV-associated Neurocognitive Disorders. In: Hu G, Xian H, Buch S, editors HIV-associated Neurocognitive Disorders (HAND). New York: Elsevier; in press.

  28. Reynolds R, Smoller S, Allen A, Nicholas PK. Health literacy and health outcomes in persons living with HIV disease: a systematic review. AIDS Behav. 2019;23:3024–43. https://doi.org/10.1007/s10461-019-02432-9.

    Article  PubMed  Google Scholar 

  29. Walker RL, Hong JH, Talavera DC, Verduzco M, Woods SP. Health literacy and current CD4 cell count in a multiethnic US sample of adults living with HIV infection. Int J STD AIDS. 2018;29:498–504. https://doi.org/10.1177/0956462417738.

    Article  PubMed  Google Scholar 

  30. Woods SP, Teixeira AL, Martins LB, Fries GR, Colpo GD, Rocha NP. Accelerated epigenetic aging in older adults with HIV disease: associations with serostatus, HIV clinical factors, and health literacy. GeroScience. 2023;1–9. https://doi.org/10.1007/s11357-023-00759-9.

  31. Bennett JS, Boyle PA, James BD, Bennett DA. Correlates of health and financial literacy in older adults without dementia. BMC Geriatr. 2012;12:1–9. https://doi.org/10.1186/1471-2318-12-30.

    Article  Google Scholar 

  32. Cho YI, Lee S-YD, Arozullah AM, Crittenden KS. Effects of health literacy on health status and health service utilization amongst the elderly. Soc Sci Med. 2008;66:1809–16. https://doi.org/10.1016/j.socscimed.2008.01.003.

    Article  PubMed  Google Scholar 

  33. Depp CA, Glatt SJ, Jeste DV. Recent advances in research on successful or healthy aging. Curr Psychiatry Rep. 2007;9:7–13. https://doi.org/10.1007/s11920-007-0003-0.

    Article  PubMed  Google Scholar 

  34. Woods SP, Morgan EE, Loft S, Matchanova A, Verduzco M, Cushman C. Supporting strategic processes can improve time-based prospective memory in the laboratory among older adults with HIV disease. Neuropsychology. 2020;34(3):249–63. https://doi.org/10.1037/neu0000602.

    Article  PubMed  Google Scholar 

  35. Woods SP, Iudicello JE, Morgan EE, Verduzco M, Smith TV, Cushman C, et al. Household everyday functioning in the internet age: online shopping and banking skills are affected in HIV- associated neurocognitive disorders. J Int Neuropsychol Soc. 2017;23:605–15. https://doi.org/10.1017/S1355617717000431.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83. https://doi.org/10.1016/0021-9681(87)90171-8.

    Article  CAS  PubMed  Google Scholar 

  37. Casaletto KB, Umlauf A, Beaumont J, Gershon R, Slotkin J, Akshoomoff N, et al. Demographically corrected normative standards for the English version of the NIH Toolbox Cognition Battery. J Int Neuropsychol Soc. 2015;21:378–91. https://doi.org/10.1017/S1355617715000351.

    Article  PubMed  PubMed Central  Google Scholar 

  38. McNair DM, Lorr M, Droppleman LF. Manual for the profile of mood states. San Diego: EdITS Educational and Industrial Testing Service; 1981.

    Google Scholar 

  39. World Health Organization (WHO). Composite international diagnostic interview (CIDI, version 2.1). Geneva Switz: World Health Organ; 1998.

    Google Scholar 

  40. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179–86.

    Article  CAS  PubMed  Google Scholar 

  41. Karnofsky DA, Burchenal JH. The clinical evaluation of chemotherapeutic agents in cancer. Maclead CM. Evaluation of chemotherapeutic agents. New York: Columbia University Press; 1949. 191–205.

    Google Scholar 

  42. Davis TC, Long SW, Jackson RH, Mayeaux E, George RB, Murphy PW, et al. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993;25:391–5.

    CAS  PubMed  Google Scholar 

  43. Chew LD, Bradley KA, Boyko EJ. Brief questions to identify patients with inadequate health literacy. Fam Med. 2004;36(8):588–94.

    PubMed  Google Scholar 

  44. Weiss BD, Mays MZ, Martz W, Castro KM, DeWalt DA, Pignone MP, et al. Quick assessment of literacy in primary care: the newest vital sign. Ann Fam Med. 2005;3:514–22. https://doi.org/10.1370/afm.405.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Mcdonald-Miszczak L, Maris P, Fitzgibbon T, Ritchie G. A pilot study examining older adults’ beliefs related to medication adherence: the BERMA survey. J Aging Health. 2004;16:591–614. https://doi.org/10.1177/0898264304265772.

    Article  PubMed  Google Scholar 

  46. Field-Fote E. Mediators and moderators, confounders and covariates: exploring the variables that illuminate or obscure the active ingredients in neurorehabilitation. J Neurol Phys Ther. 2019;43:83–4. https://doi.org/10.1097/NPT.0000000000000275.

    Article  PubMed  Google Scholar 

  47. Paasche-Orlow MK, Parker RM, Gazmararian JA, Nielsen-Bohlman LT, Rudd RR. The prevalence of limited health literacy. J Gen Intern Med. 2005;20:175–84. https://doi.org/10.1111/j.1525-1497.2005.40245.x.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Cavanaugh K, Huizinga MM, Wallston KA, Gebretsadik T, Shintani A, Davis D, et al. Association of numeracy and diabetes control. Ann Intern Med. 2008;148:737–46. https://doi.org/10.7326/0003-4819-148-10-200805200-00006.

    Article  PubMed  Google Scholar 

  49. Giordano TP. The HIV treatment cascade—a new tool in HIV prevention. JAMA Intern Med. 2015;175(4):596–7. https://doi.org/10.1001/jamainternmed.2014.8199.

    Article  PubMed  Google Scholar 

  50. Lee MK, Oh J. Health-related quality of life in older adults: its association with health literacy, self-efficacy, social support, and health-promoting behavior. Healthc MDPI. 2020;8(4):407. https://doi.org/10.3390/healthcare8040407.

    Article  Google Scholar 

Download references

Acknowledgements

The authors are grateful to the UC San Diego HIV Neurobehavioral Research Program (HNRP) Group (I. Grant, PI) for their infrastructure support; in particular, we thank Donald Franklin, Dr. Erin Morgan, Clint Cushman, and Stephanie Corkran for their assistance with data processing, Marizela Verduzco for her assistance with study management, Drs. Scott Letendre and Ronald J. Ellis for their assistance with the neuromedical aspects of the parent project, and Dr. J. Hampton Atkinson and Jennifer Marquie Beck and their assistance with participant recruitment and retention. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the United States Government. The authors thank the study volunteers for their participation.

Funding

This study was supported by NIH grants R01-MH073419, R21-MH098607 and P30-MH62512.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Houston, Houston, TX, United States of America

    Elliott Michael Gomez, Steven Paul Woods & Ilex Beltran-Najera

  2. Department of Psychology, University of Houston, 3695 Cullen Boulevard ,126 Heyne Building (Ste. 239d), 77004-5022, 713-743-6415, Houston, TX, United States of America

    Steven Paul Woods

Authors
  1. Elliott Michael Gomez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Steven Paul Woods
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ilex Beltran-Najera
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steven Paul Woods.

Ethics declarations

Competing interests

The authors have no competing interests to declare that are relevant to the content of this article.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gomez, E.M., Woods, S.P. & Beltran-Najera, I. Successful Aging is Associated with Better Health Literacy in Older Adults with HIV Disease. AIDS Behav 28, 811–819 (2024). https://doi.org/10.1007/s10461-023-04183-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-023-04183-0

Keywords

Palabras Clave

Search

Navigation