Seth C. Kalichman|Chauncey Cherry|Moira O. Kalichman|Christina M. Amaral|Denise White|Tamar Grebler|Lisa A. Eaton|Dean G. Cruess|Mervi Detorio|Angela M. Caliendo|Raymond F. Schinazi
Randomized Clinical Trial of HIV Treatment Adherence Counseling Interventions for People Living With HIV and Limited Health Literacy
University of Connecticut|University of Connecticut|University of Connecticut|University of Connecticut|University of Connecticut|University of Connecticut|University of Connecticut|University of Connecticut|Emory University|Emory University|Emory University
limited health literacy known barrier medication adherence among people living hiv adherence improvement interventions urgently needed vulnerable populationthis study tested efficacy pictographguided adherence skillsbuilding counseling intervention limited literacy adults living hivmen women living hiv receiving antiretroviral therapy n 446 scored 90 correct test functional health literacy partitioned marginal lower literacy groups randomly allocated 1 3 adherencecounseling conditions 1 pictographguided adherence counseling 2 standard adherence counseling 3 general health improvement counseling participants followed 9 months postintervention unannounced pill count adherence blood plasma viral load primary end pointspreliminary analyses demonstrated integrity trial 90 participants retained generalized estimating equations showed significant interactions counseling conditions levels participant health literacy across outcomes participants marginal health literacy pictographguided standardcounseling conditions demonstrated greater adherence undetectable hiv viral loads compared general health counseling contrast contrary hypotheses participants lower health literacy skills general health improvement counseling demonstrated greater adherence compared 2 adherence counseling conditionspatients marginal literacy skills benefit adherence counseling regardless pictographic tailoring patients lower literacy skills may require intensive providerdirected interventions