Evidence map›Paper›PMID 32202047›Full record

ArticleJournal of the International AIDS Society2020

The relationships between cognitive function, literacy and HIV status knowledge among older adults in rural South Africa.

Molly Rosenberg, F Xavier Gómez-Olivé, Ryan G Wagner, Julia Rohr, Collin F Payne, Lisa Berkman, Kathleen Kahn, Stephen Tollman, Till Bärnighausen, Lindsay C Kobayashi

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the International AIDS Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.2field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 6 countries.

Molly RosenbergDepartment of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.ORCID 0000-0001-6679-6791
F Xavier Gómez-OlivéMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Ryan G WagnerMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Julia RohrCenter for Population and Development Studies, Harvard University, Cambridge, MA, USA.
Collin F PayneSchool of Demography, Research School of Social Sciences, Australian National University, Canberra, Australia.
Lisa BerkmanMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Kathleen KahnMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Stephen TollmanMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Till BärnighausenMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Lindsay C KobayashiDepartment of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
University of the Witwatersrand · ZAHarvard University · USAustralian National University · AUIndiana University Bloomington · USUniversity of Michigan · US

Funding

SOCIAL AND ECONOMIC PREDICTORS OF PHYSICAL AND COGNITIVE FUNCTIONP01AG041710 · NIA · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI LISA F BERKMAN · 2013 to 2026
$37.3M
Training Tanzanian Researchers for HIV/AIDS Implementation ScienceD43TW009775 · FIC · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Wafaie W Fawzi, Christopher Sudfeld · 2015 to 2026
$3.0M
New Methods for the design and evaluation of large HIV prevention interventionsR01AI112339 · NIAID · YALE UNIVERSITY · PI SPIEGELMAN, DONNA L · 2014 to 2017
$2.7M
Causal Pathways to population health impact of HIV antiretroviral treatmentR01HD084233 · NICHD · UNIVERSITY OF KWAZULU-NATAL · PI BARNIGHAUSEN, TILL, TANSER, FRANK COURTENEY · 2015 to 2021
$2.3M
Can HIV Hot-Spots be eradicated? An intervention to decrease HIV transmission to young women in rural KwaZulu-Natal South AfricaR01AI124389 · NIAID · UNIVERSITY OF KWAZULU-NATAL · PI BARNIGHAUSEN, TILL, TANSER, FRANK COURTENEY · 2016 to 2020
$2.1M
FIC NIH HHS D43 TW009775NIAID NIH HHS R01 AI112339NIAID NIH HHS R01 AI124389NIA NIH HHS P01 AG041710NICHD NIH HHS R01 HD084233Wellcome TrustWellcome Trust 058893/Z/99/AWellcome Trust 069683/Z/02/ZWellcome Trust 085477/B/08/ZWellcome Trust 085477/Z/08/Z
6 · The paper itself

Abstract

introductionAlthough HIV prevalence is exceptionally high in South Africa, HIV testing rates remain below targeted guidelines. Older adults living with HIV are substantially more likely to remain undiagnosed than younger people. Cognitive function and literacy could play key roles in HIV status knowledge due to the decision-making processes required around weighing the costs and benefits of testing, navigating testing logistics and processing results. We aimed to assess the independent relationships among each of cognitive function, literacy and education with HIV status knowledge in a population-based sample of older adults living in a rural South African community with high HIV prevalence.

methodsWe analyzed data from a population-based study of 5059 men and women aged 40 years and older in rural South Africa (Health and Aging in Africa: A Longitudinal Study of an INDEPTH community (HAALSI)). HAALSI surveys, conducted between 2014 and 2015, queried self-reported literacy, educational attainment and HIV status knowledge. Laboratory tests were conducted to assess true HIV sero-status. Cognitive function was assessed with a battery of cognitive tests measuring time orientation, immediate and delayed recall, and numeracy and coded using confirmatory factor analysis as a z-standardized latent variable. We estimated the relationship between the outcome of HIV status knowledge and each of three exposures: (1) latent cognitive z-score, (2) literacy and (3) education, using confounder-adjusted modified Poisson regression models in the study population overall and stratified by HIV sero-status.

resultsWe found that HIV status knowledge was higher among those with higher cognitive z-scores (adjusted Prevalence Ratio (aPR) (95% CI): 1.18 (1.14, 1.21) per standard deviation unit), and among literate participants (aPR (95% CI): 1.24 (1.16, 1.32) vs. non-literate participants). Taken together, the associations with literacy and cognitive function completely attenuated the otherwise positive association between educational attainment and HIV status knowledge. The magnitudes of effect were generally similar among laboratory-confirmed HIV-negative and HIV-positive participants.

conclusionsCampaigns that target older adults in rural South Africa with HIV testing messages should carefully consider the cognitive and literacy levels of the intended audience. Innovations to ease the cognitive load associated with HIV testing could prove fruitful to increase HIV status knowledge.

Indexed as

CognitionLiteracyAdultAgedAged, 80 and overFemaleHealth Knowledge, Attitudes, PracticeHealth StatusHIV InfectionsHumansLongitudinal StudiesMaleMiddle AgedPrevalenceRural PopulationSelf Reportcognitive functioneducationHIV testingliteracyolder adultsSouth Africa

Identifiers

PMID32202047
PMCPMC7086300
OpenAlexW3012614641

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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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.