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Published on: March 30, 2014
Literacy, social stigma, and HIV medication adherence
Katherine R Waite1, Michael Paasche-Orlow, Lance S Rintamaki
1Health Literacy and Learning Program, Institute for Healthcare Studies, Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA. k-waite@northwestern.edu
Journal of General Internal Medicine
|June 20, 2008
Summary
Low literacy is a significant risk factor for poor HIV medication adherence. Social stigma acts as a mediator in this relationship, highlighting the need for psychosocial interventions.
Area of Science:
- Public Health
- Health Disparities
- HIV/AIDS Research
Background:
- Prior research indicates a correlation between limited literacy and suboptimal HIV medication adherence.
- The specific mechanisms driving this association require further investigation.
Purpose of the Study:
- To investigate the mediating role of social stigma in the relationship between literacy and self-reported adherence to HIV medications.
Main Methods:
- Utilized structured patient interviews with literacy assessments (REALM) and medical chart reviews.
- Included 204 patients from infectious disease clinics in Shreveport, LA, and Chicago, IL.
- Measured stigma using items from the Patient Medication Adherence Questionnaire (PMAQ).
Main Results:
- 30.4% of patients reported suboptimal adherence; 31.4% had marginal or low literacy.
- Low literacy was associated with a 3.3-fold increased likelihood of non-adherence to antiretroviral regimens (p < 0.001).
- Perceived social stigma significantly mediated the link between literacy and medication adherence (AOR 3.1).
Conclusions:
- Low literacy is a key risk factor for poor HIV medication adherence.
- Perceived social stigma plays a crucial mediating role in this relationship.
- HIV interventions for low-literacy populations should integrate psychosocial strategies to address stigma.
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