Low Health Literacy Leads to Significantly Worse Health Outcomes for AIDS Patients
HIV-infected patients who are unable to read and understand basic health care information tend to have "significantly worse health outcomes," according to a study published in the December issue of the Journal of Acquired Immune Deficiency Syndromes. Reuters Health reports that researchers, using the reading comprehension scale of the Test of Functional Health Literacy in Adults, classified 25% of the 339 HIV-positive individuals studied as having lower health literacy. These individuals were found to have significantly higher viral load levels, lower CD4 cell counts and a decreased likelihood of receiving antiretroviral medications than those with higher health literacy. Dr. Seth Kalichman, lead researcher at the Medical College of Wisconsin, said, "Because AIDS affects populations of young people with disadvantaged educations and people living in the developing world, we thought it important to test whether reading ability interferes with consistently taking medications for HIV infection. This study is the first to demonstrate that people with HIV who have low reading ability have far more difficulty adhering to their medications and have more serious immune system damage related to poor medication adherence." In addition, patients with lower health literacy "perceived their health as poorer," a notion associated with progression to AIDS and greater number of hospitalizations because of patients' distrust of health care providers and disbelief that treatment could be effective. For these patients, Drs. Kalichman and David Rompa advise simplified instructions, nonverbal forms of communication, such as color-coded medicine containers, and use of pictographs for medical instructions to achieve "significant health savings." Kalichman noted, "The payoff is improved health and therefore less use of hospital care and other expensive services. ... [W]hen treatments fail, the costs can even be higher because of issues of medication resistance, so interventions to improve medication adherence for low-literacy populations will ultimately save health care costs" (Gale, Reuters Health, 1/15).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.