Health literacy in HIV treatment: accurate understanding of key biological treatment principles is not required for good ART adherence.
Health literacy in HIV treatment: accurate understanding of key biological treatment principles is not required for good ART adherence.
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DOI：
10.1007/s10461-014-0931-8
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发表时间：
2015-04
影响因子：
4.4
通讯作者：
Wilson IB
中科院分区：
文献类型：
--
作者：
Laws MB;Danielewicz M;Rana A;Kogelman L;Wilson IB
关于健康素养与艾滋病毒结果之间关系的研究结果并不一致。健康素养此前已作为一般功能素养实施，但不包括有关艾滋病毒疾病和治疗的内容知识。对美国 2 个城市的艾滋病毒感染者进行半结构化访谈，包括有关艾滋病毒的病因学、病理生理学和治疗的问题。我们比较了对生物医学概念的反应。 32 名受访者的人口结构各不相同。尽管大多数人都知道艾滋病毒会降低免疫系统，但没有人能够解释病毒的性质或抗逆转录病毒 (ARV) 药物的作用机制。不到一半的人准确地报告说，需要高 CD4+ 细胞计数和低病毒载量。少数人理解耐药性的概念。虽然大多数人认为严格遵守抗逆转录病毒疗法对于维持健康很重要，但三人认为定期中断治疗是有益的，三人认为他们在饮酒或使用非法药物时不应服用抗逆转录病毒药物。受访者对艾滋病毒的生物医学了解普遍非常有限，而且往往不准确。大多数人报告治疗方案依从性良好，但没有任何机制上的理由。未能在健康素养和抗逆转录病毒药物依从性之间找到一致的关系可能很大程度上是因为大多数人只是遵循医生的指示，而不需要深入了解。
Findings on the relationship between health literacy and outcomes in HIV have been inconsistent. Health literacy has previously been operationalized as general functional literacy, but has not included content knowledge about HIV disease and treatment. Semi-structured interviews with people living with HIV in 2 U.S. cities, including questions about the etiology, pathophysiology and treatment of HIV. We compared responses to biomedical conceptions. The 32 respondents were demographically diverse. Although most understood that HIV degrades the immune system, none could explain the nature of a virus, or the mechanism of antiretroviral (ARV) drug action. Fewer than half accurately reported that it is desirable to have a high CD4+ cell count and low viral load. A minority understood the concept of drug resistance. While most believed that strict adherence to ARV regimens was important to maintain health, three believed that periodic treatment interruption was beneficial, and three believed they should not take ARVs when they used alcohol or illicit drugs. Respondents generally had very limited, and often inaccurate biomedical understanding of HIV disease. Most reported good regimen adherence but did not have any mechanistic rationale for it. The failure to find a consistent relationship between health literacy and ARV adherence may be largely because most people simply follow their doctors’ instructions, without the need for deep understanding.