Katherine Waite|Michael K. Paasche?Orlow|Lance S. Rintamaki|Terry C. Davis|Michael S. Wolf
Literacy, Social Stigma, and HIV Medication Adherence
Northwestern University|Boston University|University at Buffalo, State University of New York|Louisiana State University Health Sciences Center Shreveport|Northwestern University
prior studies linked limited literacy poorer hiv medication adherence although precise causal pathways relationship initially investigatedto examine whether social stigma possible mediator relationship literacy selfreported hiv medication adherencestructured patient interviews literacy assessment supplemented medical chart review conducted among patients receiving care infectious disease clinics shreveport louisiana chicago illinois literacy measured using rapid estimate adult literacy medicine realm stigma measured using items taken patient medication adherence questionnaire pmaqtwo hundred four consecutive patients participatedapproximately onethird patients 304 less 100 adherent regimen 314 marginal 7th8th grade low 6th grade literacy multivariate analyses patients low literacy 33 times likely nonadherent antiretroviral regimens 95 ci 1387 p 0001 perceived social stigma found mediate relationship literacy medication adherence aor 31 95 ci 1377while low literacy significant risk factor improper adherence hiv medication regimens study perceived social stigma mediated relationship low literacy hiv intervention strategies may also need incorporate comprehensive psychosocial approaches overcome stigma barriers