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，HIV+患者必须达到高水平的依从性（90- 95%）。我们对HIV/AIDS患者的工作表明，由于患者不理解他们的剂量说明，可能会发生每日ARV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，并预测再填充（定量识字）。虽然散文识字率低，年龄和教育与艾滋病毒/艾滋病患者对抗逆转录病毒药物给药说明的理解不足有关，但在这一人群中，定量识字的作用在很大程度上尚未研究。此外，已知随着HIV疾病的进展和执行功能的缺陷（即，问题解决和推理）和学习/记忆与不能理解抗逆转录病毒疗法说明有关。到目前为止，还没有关于识字对抗逆转录病毒疗法理解的影响的研究说明认知障碍。由于相当大比例的HIV感染者可能存在认知障碍，因此必须考虑这种认知障碍对理解ARV药物治疗方案的影响。建议的横断面研究将评估低散文素养，低定量素养和特定的神经认知能力领域的赤字，以少数民族为样本的200 ARV natiVHIV+男性和女性的抗逆转录病毒治疗说明理解不良的关系。对抗逆转录病毒治疗方案的初步了解对于继续坚持至关重要。识别与抗逆转录病毒药物说明理解不良相关的因素是制定干预措施以改善其的必要先决条件。

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.