Optimal Treatment Adherence Counseling Outcomes for People Living with HIV and Limited Health Literacy

Abstract

Limited health literacy has been shown to contribute to poor adherence to antiretroviral therapy (ART) in people living with HIV/AIDS. Given the mixed results of previous interventions for people with HIV and low health literacy, investigating possible targets for improved adherence is warranted. The present study aims to identify the correlates of optimal and suboptimal outcomes among participants of a recent skills-based medication adherence intervention. This secondary analysis included 188 men and women living with HIV who had low health literacy and who had complete viral load data. Adherence was assessed by unannounced pill count and follow-up viral loads were assessed by blood draw. Results showed that higher levels of health literacy and lower levels of alcohol use were the strongest predictors of achieving HIV viral load optimal outcomes. The interplay between lower health literacy and alcohol use on adherence should be the focus of future research.

Keywords: HIV/AIDS; health literacy; medication adherence.

Figure 1

Flow chart of the determination of optimal outcome groups.

Figure 2

Percent of participants who achieved 85% of higher adherence by trial outcome. Note: B= baseline, Odds Ratios: B1 1.81; B2 2.76**; B3 2.98**; Time 1 (T1) 3.06**; T2 3.26**; T3 3.82**; T4 3.05**; T5 4.22**; T6 4.95**; T7 6.75**; T8 3.99**; T9 3.10**; **p<.01