Reading Is Fundamental--to Health Too

HIVers with low literacy levels often don't understand the medication instructions given them by health care providers and are therefore less likely to be compliant with treatment, study findings reported in the November issue of the American Journal of Preventive Medicine suggest. The findings also indicate that African-Americans with HIV infection are more than twice as likely to be nonadherent compared with their white counterparts. However, when the data were analyzed, lead investigator Chandra Y. Osborn, MD, of Northwestern University and her colleagues found that health literacy mediated the racial disparities. Osborn's group investigated the association between health literacy and racial differences in medication adherence. A health-related word-recognition test identified 68.6% of the patients with adequate health literacy (reading at a ninth-grade or higher level). Slightly more than 20% of the participants had marginal health literacy (seventh- to eighth-grade reading level), and about 11% had low health literacy. The researchers found that the African-Americans were 2.4 times more likely to be nonadherent to their medication regimens compared with non-African-Americans when the analysis factored in the effects of age, gender, income, number of medications, and non-HIV comorbidities. When the effects of literacy were considered, literacy was a significant predictor of nonadherence. Patients with low literacy were 2.1 times more likely to be nonadherent to their medication regimen than patients with adequate literacy.