Adherence to Combination Antiretroviral Therapies in HIV Patients of Low Health Literacy
Article first published online: 25 DEC 2001
1999 by the Society of General Internal Medicine
Journal of General Internal Medicine
Volume 14, Issue 5, pages 267–273, May 1999
How to Cite
Kalichman, S. C., Ramachandran, B. and Catz, S. (1999), Adherence to Combination Antiretroviral Therapies in HIV Patients of Low Health Literacy. Journal of General Internal Medicine, 14: 267–273. doi: 10.1046/j.1525-1497.1999.00334.x
- Issue published online: 25 DEC 2001
- Article first published online: 25 DEC 2001
- HIV infection;
- AIDS treatment;
- medication adherence
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.