TY - JOUR
T1 - Health Literacy. An Overlooked Factor in Understanding HIV Health Disparities
AU - Osborn, Chandra Y.
AU - Paasche-Orlow, Michael K.
AU - Davis, Terry C.
AU - Wolf, Michael S.
N1 - Funding Information:
Dr. Osborn conducted this research as a National Research Service Award postdoctoral fellow at the Institute for Healthcare Studies, Feinberg School of Medicine at Northwestern University under an institutional award from the Agency for Healthcare Research and Quality. Dr. Wolf is supported by a Career Development Award through the Centers for Disease Control and Prevention (K01 EH000067–01).
PY - 2007/11
Y1 - 2007/11
N2 - Background: Limited health literacy may be a contributing factor to racial disparities in health care. This study examined the mediating effect of limited health literacy on the relationship between race and HIV-medication adherence. Methods: A total of 204 patients infected with HIV were recruited from two clinics in 2001. Structured in-person interviews were conducted to obtain information on patient demographics, medication adherence, and health literacy. Multivariate regression models were run in 2006 to examine the associations among race, literacy, and HIV-medication adherence after adjusting for relevant covariates. Results: In an adjusted analysis that excluded literacy, African Americans were 2.40 times more likely to be nonadherent to their HIV-medication regimen than whites (95% confidence interval [CI]=1.14-5.08). When literacy was included in the final model, the effect estimates of race diminished 25% to nonsignificance. Literacy remained a significant independent predictor of nonadherence (adjusted odds ratio [AOR]=2.12, 95% CI=1.93-2.32). Conclusions: In this study, limited health literacy mediated the relationship between race and HIV-medication adherence. Investigators need to consider the potential utility of responding to literacy and communication barriers in health care as part of interventions to reduce racial disparities.
AB - Background: Limited health literacy may be a contributing factor to racial disparities in health care. This study examined the mediating effect of limited health literacy on the relationship between race and HIV-medication adherence. Methods: A total of 204 patients infected with HIV were recruited from two clinics in 2001. Structured in-person interviews were conducted to obtain information on patient demographics, medication adherence, and health literacy. Multivariate regression models were run in 2006 to examine the associations among race, literacy, and HIV-medication adherence after adjusting for relevant covariates. Results: In an adjusted analysis that excluded literacy, African Americans were 2.40 times more likely to be nonadherent to their HIV-medication regimen than whites (95% confidence interval [CI]=1.14-5.08). When literacy was included in the final model, the effect estimates of race diminished 25% to nonsignificance. Literacy remained a significant independent predictor of nonadherence (adjusted odds ratio [AOR]=2.12, 95% CI=1.93-2.32). Conclusions: In this study, limited health literacy mediated the relationship between race and HIV-medication adherence. Investigators need to consider the potential utility of responding to literacy and communication barriers in health care as part of interventions to reduce racial disparities.
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U2 - 10.1016/j.amepre.2007.07.022
DO - 10.1016/j.amepre.2007.07.022
M3 - Article
C2 - 17950402
AN - SCOPUS:35348833714
SN - 0749-3797
VL - 33
SP - 374
EP - 378
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
IS - 5
ER -
