ArticleHealth literacy research and practice2018
Racial Disparities in HIV Antiretroviral Medication Management are Mediated by Health Literacy.
Article in Health literacy research and practice, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- Racial/Ethnic Disparities in Health Literacy, Perception of Health Status, and Access to Healthcare Among Heart Transplant Patients of the National Institutes of Health All of Us Research Program.Journal of racial and ethnic health disparities · 2026Article
- The reciprocal relationships between loneliness and antiretroviral therapy adherence in persons with HIV: a two-wave cross-lagged model.AIDS care · 2025Observational
- Durable viral suppression among persons with HIV in the deep south: an observational study.AIDS care · 2023Observational
- Verbal Learning Mediates the Relationship Between Executive Functions and a Laboratory Task of Medication Management in HIV Disease.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2021Article
- Racial and ethnic disparities in HIV diagnoses among heterosexually active persons in the United States nationally and by state, 2018.PloS one · 2021Article
- Predictors of disparities in retention in care among African Americans living with HIV.AIDS care · 2021Article
- Health care utilization and HIV clinical outcomes among newly enrolled patients following Affordable Care Act implementation in a California integrated health system: a longitudinal study.BMC health services research · 2020Article
- The Intersection of Cognitive Ability and HIV: A Review of the State of the Nursing Science.The Journal of the Association of Nurses in AIDS Care : JANACReview
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite the availability of antiretroviral (ARV) therapy in the United States, only 30% of people living with HIV/AIDS (PLWH) in the US are virally suppressed. Nonadherence to ARVs remains the strongest correlate of viral suppression. African Americans (AA) living with HIV/AIDS remain disproportionately affected by this disease, and studies report a greater proportion of infections and deaths among this group.
objectiveEarlier studies by this team and others have shown that health literacy (HL) may negatively influence disparities in health behaviors, including management of ARV prescriptions, between AA and non-AA PLWH. This current study expands these findings and tests whether HL may explain disparities in medication management among AA and non-AA PLWH and includes important covariates and measures of participants' actual medication regimens.
methodsPLWH were recruited from HIV care clinics in the greater metropolitan area of Atlanta, GA, and completed a face-to-face study visit. A total of 699 PLWH, 65% of whom were AA, completed this study visit. Assessment of knowledge and management of participants' actual medication regimens showed highly skewed responses, demonstrating accurate verbal descriptions of ARV prescription instructions. A measure of problem-solving (how to manage a mock ARV regimen) showed significantly different performance by race and that HL measures (both reading comprehension and numeracy) mediated this relationship. KEY
resultsFindings suggest that although PLWH may be able to verbally explain how they are supposed to take their ARV medication, challenges may arise with management issues (eg, determining need for a refill, counting pills to determine if a dose was missed) and that PLWH with low HL (who are disproportionately AA) may be at greater risk for mistakes. Other characteristics, such as cognitive impairment, were also shown to influence medication management.
conclusionAttention to PLWH's potential for mismanagement of ARV and other medications is important to identify for educational interventions. PLAIN LANGUAGE SUMMARY: This study tested if problems with taking medicine to treat HIV may be caused by poor reading and math skills. Even though most people were able to correctly say how they should take their HIV pills, knowing if they had missed a pill or counting out a week's number of pills was harder for those with lower reading and math skills.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.