Michael K. Paasche?Orlow|Debbie M. Cheng|Anita Palepu|Seville Meli|Vincent Faber|Jeffrey H. Samet
Health literacy, antiretroviral adherence, and HIV-RNA suppression
Boston University|Boston University|University of British Columbia|Boston University|DM-STAT (United States)|Boston University
low health literacy associated worse adherence antiretroviral therapy art higher hivrna levels relationships evaluated longitudinal analyseswe evaluated literacy using rapid estimate adult literacy medicine realm 6th grade 7th 8th grade 9th grade hivalcohol longitudinal cohort study hivinfected persons history alcohol problems conducted 1997 2001 tested hivrna levels administered standardized questionnaire regarding demographics substance use receipt art adherence art every 6 months 7 occasions among 235 subjects art investigated relationship literacy 2 outcomes 100 3day selfreported adherence hivrna suppression 500 copiessubjects literacy levels following 14 6th grade 29 7th 8th grade 57 9th grade 66 observations 478725 subjects reported 100 3day adherence art 685 hivrna assays subjects 62 500 copies unadjusted analyses subjects lowest literacy level 6th grade higher odds adherence odds ratio 223 95 confidence interval 115 430 hivrna suppression 201 95 confidence interval 103 390 compared 9th grade literacy trend persisted longer statistically significant adjusted models adherence aor 193 95 confidence interval 086 431 hivrna suppression aor 170 95 confidence interval 079 365contrary hypothesis low literacy associated lower odds adherence virologic suppression longitudinal analysis hivinfected patients history alcohol problems indeed trends data suggest possibility low literacy may associated higher odds adherence virologic suppression counterintuitive findings underscore need pursue fuller understanding mechanisms literacy affects health outcomes