Adherence to combination antiretroviral therapies in HIV patients of low health literacy
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OBJECTIVE: To test the significance of health literacy relative to other predictors of adherence to treatment for HIV and AIDS.
PARTICIPANTS: Community sample of HIV-seropositive men (n=138) and women (n=44) currently taking a triple-drug combination of antiretroviral therapies for HIV infection; 60% were ethnic minorities, and 73% had been diagnosed with AIDS.
MEASUREMENTS: An adapted form of the Test of Health Literacy in Adults (TOFHLA), a comprehensive health and treatment interview that included 2-day recall of treatment adherence and reasons for nonadherence, and measures of substance abuse, social support, emotional distress, and attitudes toward primary care providers.
MAIN RESULTS: Multiple logistic regression showed that education and health literacy were significant and independent predictors of 2-day treatment adherence after controlling for age, ethnicity, income, HIV symptoms, substance abuse, social support, emotional distress, and attitudes toward primary care providers. Persons of low literacy were more likely to miss treatment doses because of confusion, depression, and desire to cleanse their body than were participants with higher health literacy.
CONCLUSIONS: Interventions are needed to help persons of low literacy adhere to antiretroviral therapies.
Key wordsHIV infection AIDS treatment medication adherence
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- 1.Ho DD. Therapy of HIV infections: problems and prospects. Bull NY Acad Med. 1996;73:37–45.Google Scholar
- 6.Hecht FM. Adherence to HIV Treatment. Presented at the meeting of Clinical Care of the AIDS Patients, San Francisco, Calif, December 1997.Google Scholar
- 8.Rabkin JG, Chesney M. Treatment adherence to HIV medications: the Achilles heel of the new therapeutics. In: Ostrow D, Kalichman S, eds. Behavioral and Mental Health Impacts of New HIV Therapies. New York, NY: Plenum Press. 1999.Google Scholar
- 10.Stall R, Hoff C, Coates TJ, et al. Decisions to get HIV tested and to accept antiretroviral therapies among gay/bisexual men: implications for secondary prevention efforts. J AIDS Hum Retrovir. 1996;11:151–60.Google Scholar
- 17.Cella D. The Functional Assessment of Cancer Therapy Scales and the Functional Assessment of HIV Infection Scale, Version 3. Chicago, Ill: Rush-Presbyterian-St. Lukes Medical Center. 1994.Google Scholar
- 18.Hecht FM, Colfax G, Swanson M, Cesney M. Adherence and effectiveness of protease inhibitors in clinical practice. Presented at the 5th Annual Retroviral Conference, Chicago, Ill, 1998.Google Scholar
- 19.Hopewell PC. Tuberculosis in persons with human immunodeficiency virus infection. In: Sande MA, Volberding PA, eds. The Medical Management of AIDS. 5th ed. Philadelphia, Pa: Saunders; 1997:311–26.Google Scholar
- 21.Kalichman SC. Understanding AIDS: Advances in Research and Treatment. 2nd ed. Washington, DC: American Psychological Association; 1998.Google Scholar