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Lower Neurocognitive Functioning Disrupts the Effective Use of Internet-Based Health Resources in HIV Disease: The Mediating Effects of General Health Literacy Capacity

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Abstract

HIV-associated neurocognitive impairment is an independent predictor of low general health literacy, which can be associated with poor disease outcomes (e.g., viremia). Given the increasing frequency with which health behaviors occur in an online environment (e.g., health information seeking, provider interactions), there is a specific need to understand the predictors of electronic health (eHealth) literacy of persons living with HIV disease. In this study, 90 HIV+ persons completed the eHealth Literacy Scale (eHEALS), which measures one’s awareness, skills and evaluation of online health resources. Participants also completed a comprehensive battery of clinical neurocognitive tests and well-validated performance-based measures of general health literacy capacity (e.g., knowledge, numeracy). Results showed that, independent of education, lower neurocognitive function was moderately related to lower eHEALS scores, particularly in the domains of learning and motor skills. Of particular note, general health literacy capacity emerged as a significant mediator of the relationship between neurocognition and eHealth literacy. Thus, the adverse effects of neurocognition on health literacy capacity carries a downstream adverse influence on HIV+ persons’ awareness, skills, and evaluation of health-related resources in the online environment.

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Acknowledgements

We extend our gratitude to Marizela Verduzco who coordinated all aspects of this study, to Richard Seghers and Roberto Gallardo for their assistance with participant identification and scheduling, to Donald Franklin, Stephanie Corkran, Clint Cushman, and Dr. Erin E. Morgan for their help with data processing, Drs. Scott Letendre and Ronald J. Ellis for their assistance with the neuromedical aspects of the parent projects, and Dr. J. Hampton Atkinson and Jennifer Marquie Beck and their assistance with participant recruitment and retention.

Funding

Funding

This study was primarily supported by NIH Grant R21-MH098607, with additional support from R01-MH073419, P50-DA026306, U24-MH100928, and P30-MH62512.

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Authors and Affiliations

  1. Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77004-5022, USA

    Steven Paul Woods & Kelli L. Sullivan

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  1. Steven Paul Woods
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Correspondence to Steven Paul Woods.

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All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Woods, S.P., Sullivan, K.L. Lower Neurocognitive Functioning Disrupts the Effective Use of Internet-Based Health Resources in HIV Disease: The Mediating Effects of General Health Literacy Capacity. AIDS Behav 23, 676–683 (2019). https://doi.org/10.1007/s10461-018-2350-8

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