Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review

Abstract

Background: Scholars describe poor health literacy as a "silent epidemic, " which is challenging the functioning of healthcare systems all over the world. Health literacy is mainly meant as an individual trait which concerns the ability to obtain, process, and understand basic health information in order to effectively navigate the health system. Low health literate patients perceive poor self-efficacy dealing with their health conditions, are not willing to be involved in the provision of care, show larger risks of hospitalization and mortality, and are not aware about the determinants of well-being. Hence, limited health literacy has been associated with inadequate management of long-term conditions; nonetheless, several authors argue that health literacy has been an overlooked factor dealing with HIV. Methods: This study is aimed at discussing the effects of poor health literacy on people living with HIV, drawing from the findings of a narrative literature review which involved 41 papers retrieved from the databases "Scopus-Elsevier" and "PubMed. " Results: The scientific literature is not consistent dealing with the relationship between health literacy and HIV treatment. For example, health literate patients seem to better understand their health conditions; on the other hand, people living with poor health literacy are likely to report higher compliance with providers' prescriptions, blindly trusting healthcare professionals. Conclusions: Poor health literacy is a social barrier to access healthcare services and to appropriate health treatment among patients living with HIV. Tailored interventions should be aimed at enhancing the health skills of patients affected by HIV infection to improve their ability to navigate the health system.

Determinants of Virological Response to Antiretroviral Therapy: Socio-Economic Status Still Plays a Role in the Era of cART. Results from the ANRS-VESPA 2 Study, France

“…Health literacy was associated with a poorer response to cART in bivariate analysis, but the association was no longer significant after adjustment. However, our indicator of health literacy only took into account the patients' knowledge of CD4 + T-cell count and viral load evolution during treatment, which is only one of all the health literacy dimensions, and can be measured with specific tools [48][49][50]. We did not find an association with depression, even though such an association has been largely reported in the literature [7,51].…”

Epidemiologic and viral predictors of antiretroviral drug resistance among persons living with HIV in a large treatment program in Nigeria

“…However, Rachlis et al [40] have shown in a systematic review of studies in LMICs that higher education was associated with good adherence. A lower level of general education and poorer literacy may impact negatively on some patients' ability to adhere, while a higher level of education has a positive impact [41].…”

Barriers and Facilitators toward HIV Testing and Health Perceptions among African-American Men Who Have Sex with Women at a South Side Chicago Community Health Center: A Pilot Study

“…The degree to which health literacy influences HIV testing behavior is currently unclear, but other data have shown that higher health literacy is associated with better HIV-related health behaviors and outcomes. For instance, one study found that educational attainment of high school or less is associated with decreased testing frequency (24), and among people who already have a diagnosis of HIV, there is some evidence of increased medication adherence and improved outcomes among people with higher levels of health literacy (25, 26). However, additional data suggest that low health literacy may facilitate testing.…”