Adherence to HIV therapy linked to health literacy

Adherence to HIV therapy linked to health literacy
NEW YORK (Reuters Health) - HIV infected patients with lowliteracy levels often don't understand the medicationinstructions offered by healthcare providers and are thereforemuch less likely to be compliant with treatment, study findingssuggest.
The findings also indicate that African Americans with HIVinfection are more than twice as likely to be nonadherentcompared with their white counterparts. However, when the datawere analyzed, lead investigator Dr. Chandra Y. Osborn, atNorthwestern University, Chicago, and colleagues found thathealth literacy mediated the racial disparities.
The level of health literacy was determined by thesubjects' overall literacy skills, the researchers explain.Past studies have shown that low health literacy is associatedwith poor health outcomes and is more common among AfricanAmericans than whites.
Osborn's group investigated the association between healthliteracy and racial differences in medication adherence overtime among 204 HIV-infected patients attending outpatientclinics in Chicago and Shreveport, Louisiana. The patients, 80percent male and 45 percent African American, were 40 years ofage, on average.
Overall, more than 70 percent of the study participantswere taking three or more HIV medications and more than halfwere being treated for other chronic illnesses, theinvestigators report in the American Journal of PreventiveMedicine.
A health-related word recognition test identified 68.6percent of the patients with adequate health literacy (readingat a ninth grade or higher level). Slightly more than 20percent of the participants had marginal health literacy (7thto 8th grade reading level) and about 11 percent had low healthliteracy.
The researchers found that the African Americans were 2.4times more likely to be non-adherent to their medicationregimens compared with non-African Americans when the analysisfactored in the effects of age, gender, income, number ofmedications, and non-HIV comorbidities, Osborn said.
Osborn told Reuters Health that when the effects ofliteracy were considered, "literacy was a significant predictorof non-adherence, such that patients with low literacy were 2.1times more likely to be non-adherent to their medicationregimen than patients with adequate literacy."
Limited health literacy is a potentially modifiable barrierto medication adherence, the investigators note. Those at riskfor medication non-adherence may benefit from culturallyrelevant health education materials and medication labelingwritten for all literacy levels.
SOURCE: American Journal of Preventive Medicine, November2007