Association Between Health Literacy and HIV Treatment Adherence: Further Evidence from Objectively Measured Medication Adherence
Open accessAbstract
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.
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A diagnosis of HIV entails learning new information about viral load, CD4+ lymphocyte count, and other health information.
“A diagnosis of HIV entails learning new information about viral load, CD4+ lymphocyte count, and a host of other health information (80).”
From HIV and Aging: State of Knowledge and Areas of Critical Need for Research. A Report to the NIH Office of AIDS Research by the HIV and Aging Working Group (2012) · cites this paper as [80]
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- Authors
- Kalichman, S. C., Pope, H., White, D., Cherry, C., Amaral, C. M., Swetzes, C., Flanagan, J., & Kalichman, M. O.
- Affiliations
- University of Connecticut (US)
- Corresponding author
- Kalichman, Seth C.
- Venue
- Journal of the International Association of Physicians in AIDS Care
- Publisher
- SAGE Publications
- Published
- 2008-12
- Volume
- 7
- Issue
- 6
- Pages
- 317-323
- ISSN
- 1081-454X (ISSN-L)
- 1545-1097
- PMC
- PMC3015090
- OpenAlex
- W2098609919
- Cited by
- 155
- References
- 30
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 2 · 2023: 5 · 2022: 5 · 2021: 14 · 2020: 11 · 2019: 12 · 2018: 9 · 2017: 12 · 2016: 11 · 2015: 10 · 2014: 9 · 2013: 20 · 2012: 10
- FWCI
- 3.66
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the International Association of Physicians in AIDS Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH71164, R01MH082633, R01MH071164, R01-MH82633)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Keywords
- health literacy, HIV treatment adherence, antiretroviral therapy, medication adherence, objective adherence measurement, HIV
- MeSH terms
- Drug Administration Schedule, Educational Status, Female, Health Education, Humans, Interviews as Topic, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Patient Compliance, Surveys and Questionnaires, Telephone, HIV Infections, CD4 Lymphocyte Count, Anti-HIV Agents, Viral Load, Medication Adherence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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