Health literacy has been shown to be related to multiple health outcomes and may be an issue of great importance in the management of a chronic and complicated disease like HIV. Functional health literacy (FHL) may be a factor that affects medication adherence in people living with HIV/AIDS.
This study sought to describe FHL in people living with HIV/AIDS who are taking antiretroviral medication and to investigate functional health literacy and medication taking self-efficacy as possible predictors of HIV medication adherence. Additionally, the study explored the relationship between FHL and selected variables from SCT.
This secondary data analysis was a cross-sectional descriptive study. The sample included 335 individuals living with HIV who were taking antiretroviral medications. Measures of central tendency and variance were used to describe continuous variables. Bivariate analyses and logistic regression were conducted to examine the univariate relationships between and among the key variables of interest. Multivariate logistic regression was used to jointly examine potential predictors of adherence.
Overall, 10.4% (n=35) of the participants were classified as having inadequate/marginal FHL. Race, educational level, and the interaction between race and educational level predicted FHL in this sample. Sixty seven percent (n=223) of participants had adherence rates less than 85%, based on days with correct intake. In bivariate analysis, FHL was not significantly related to medication adherence, although there was a non-significant trend suggesting that people with lower FHL may demonstrate lower adherence (รท2 = 3.17, p=.075). FHL was also not related to self-efficacy beliefs. In multivariate logistic regression, non-white participants, people with lower self-efficacy beliefs, and younger individuals were more likely to demonstrate poorer adherence.
Using multivariate logistic regression, medication adherence was significantly related to mental health functioning, role of state of mind in controlling illness, negative self-image related to HIV-stigma, and two interaction terms (mental health functioning and negative self-image related to HIV-stigma; personalized stigma and FHL), after controlling for race and age.
The proportion of people with lower FHL was lower than expected. Further research is needed to fully understand the scope and breadth of FHL issues for people living with HIV. Further research is needed to understand the disparate findings related to FHL and treatment adherence. Finally, these results indicate that there remains much work to be done in identifying true predictors of medication adherence in people living with HIV.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-01022008-153542 |
| Date | 23 January 2008 |
| Creators | Colbert, Alison Merece |
| Contributors | Helen Burns, PhD, RN, Anthony Silvestre, PhD, Lora E. Burke, PhD, MPH, FAAN, Judith A. Erlen, PhD, RN, FAAN, Susan Sereika, PhD |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-01022008-153542/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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