Literacy & cognitive skills to understand HIV regimens

为了获得抗逆转录病毒（ARV）治疗的临床益处，艾滋病毒阳性患者必须达到高水平的依从性（90- 95%）。我们对艾滋病毒/艾滋病患者的工作表明，由于患者不理解其给药说明，可能会出现每日抗逆转录病毒药物剂量错误。因此，如果患者在治疗开始时不能理解药物说明，那么他们就不能期望随着时间的推移准确地遵循这些方案。功能性健康素养是指阅读和理解处方瓶、预约单和其他材料的能力，这些材料确保了患者角色的成功运作（散文素养）。它还包括使用数学技能来计划每天/每周的剂量数量和时间，并预测补充（定量素养）。尽管较低的散文读写能力、年龄和教育程度与艾滋病毒/艾滋病患者对抗逆转录病毒药物剂量说明的理解不足有关，但定量读写能力在这一人群中的作用在很大程度上尚未得到研究。此外，已知随着艾滋病毒疾病的进展会出现认知障碍，执行功能（即解决问题和推理）和学习/记忆的缺陷与无法理解抗逆转录病毒治疗方案的说明有关。迄今为止，没有关于读写能力对抗逆转录病毒治疗方案理解的影响的研究考虑到认知障碍。由于相当大比例的艾滋病毒感染患者可能存在认知障碍，因此必须考虑到这种障碍对了解抗逆转录病毒药物治疗方案的影响。这项横断面研究将评估200名ARV原生HIV阳性男性和女性的少数民族样本中，低散文读写能力、低定量读写能力和特定神经认知能力领域的缺陷与对ARV治疗方案说明理解不佳的关系。初步了解抗逆转录病毒治疗方案对于持续坚持治疗至关重要。确定与对抗逆转录病毒药物说明书理解不足有关的因素是制定干预措施以改善这种情况的必要先决条件。

To derive the clinical benefits of antiretroviral (ARV) therapy, HIV+ patients must attain high levels of adherence (90-95 percent). Our work with HIV/AIDS patients has indicated that errors in daily ARV dosing may occur because patients did not understand their dosing instructions. Therefore, if patients are not able to understand medication instructions at the outset of treatment, then they cannot be expected to accurately follow those regimens over time. Functional health literacy refers to the ability to read and comprehend prescription bottles, appointment slips and other materials that ensure successful functioning in the patient role (prose literacy). It also includes using mathematical skills to plan the number and timing of doses each day/week and to anticipate refills (quantitative literacy). Although low prose literacy, age and education have been associated with poor understanding of ARV dosing instructions in HIV/AIDS patients, the role of quantitative literacy has been largely unstudied in this population. Furthermore, cognitive impairment is known to occur as HIV disease progresses and deficits in executive functions (i.e., problem-solving and reasoning) and learning/memory have been linked to failure to comprehend ARV regimen instructions. No studies on the effects of literacy on ARV regimen comprehension to date have accounted for cognitive impairment. Because a substantial proportion of HIV infected patients are likely to be cognitively impaired, the influence of such impairment on understanding of ARV medication regimens must be considered. The proposed cross-sectional study will assess the relation of low prose literacy, low quantitative literacy and deficits in specific neurocognitive ability domains to poor comprehension of ARV regimen instructions in a mostly ethnic minority sample of 200 ARV naTve HIV+ men and women. Initial comprehension of ARV regimens is essential for continued adherence. Identification of factors related to poor comprehension of ARV medication instructions is a necessary prerequisite for developing interventions to improve it.