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Association Between Health Literacy and HIV Treatment Adherence: Further Evidence from Objectively Measured Medication Adherence

University of Connecticut, Storrs, Connecticut, seth.k{at}uconn.edu

Howard Pope

University of Connecticut, Storrs, Connecticut

Denise White

University of Connecticut, Storrs, Connecticut

Chauncey Cherry, MPH

University of Connecticut, Storrs, Connecticut

Christina M. Amaral

University of Connecticut, Storrs, Connecticut

Connie Swetzes

University of Connecticut, Storrs, Connecticut

Jody Flanagan

University of Connecticut, Storrs, Connecticut

Moira O. Kalichman, MSW

University of Connecticut, Storrs, Connecticut

Background. People with lower-health literacy are vulnerable to health problems. Studies that have examined the association between literacy and medication adherence have relied on self-reported adherence, which is subject to memory errors, perhaps even more so in people with poor literacy. Purpose. To examine the association between health literacy and objectively assessed HIV treatment adherence. Methods. Men and women (N = 145) receiving antiretroviral therapy completed a test of health literacy and measures of common adherence markers. Medication adherence was monitored by unannounced pill counts. Results. Median adherence was 71%; participants with lower-health literacy also demonstrated poorer adherence compared to participants with higher literacy. Hierarchical regression showed literacy predicted adherence over and above all other factors. Sensitivity tests showed the same results for 80% and 90% adherence. Conclusions. The association between literacy and adherence appears robust and was confirmed using an objective measure of medication adherence.

Key Words: HIV/AIDS • adherence • antiretroviral therapy • health literacy

This version was published on December 1, 2008

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 7, No. 6, 317-323 (2008)
DOI: 10.1177/1545109708328130


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