Health literacy and patient knowledge in a Southern US HIV clinic

Pharmaceutical management of HIV infection is complex, and proper adherence to antiretroviral regimens is contingent on active patient involvement in treatment. We examined the relationship between patient understanding of HIV and its treatment and health literacy. Structured interviews were conducted with 157 HIV-infected individuals receiving care at a community-based clinic in Shreveport, Louisiana, USA. In all, 48% of patients were reading below a 9th grade level. One-third of patients could not name their HIV medications and this was significantly related to low literacy (P < 0.01). Two-thirds of those reading below the 9th grade level did not know how to take their medications correctly (P < 0.05), and 75% did not know the meaning of a CD4 count or viral load (P < 0.001). Patients with low literacy skills were more likely to state that their physician was their sole source of HIV information (P < 0.005). Physicians may require training to appropriately convey health information to patients of low literacy.