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Colbert, Alison Merece (2008) FUNCTIONAL HEALTH LITERACY, MEDICATION-TAKING SELF-EFFICACY AND HIV MEDICATION ADHERENCE. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Health literacy has been shown to be related to multiple health outcomes and may be an issue of great importance in the management of a chronic and complicated disease like HIV. Functional health literacy (FHL) may be a factor that affects medication adherence in people living with HIV/AIDS.This study sought to describe FHL in people living with HIV/AIDS who are taking antiretroviral medication and to investigate functional health literacy and medication taking self-efficacy as possible predictors of HIV medication adherence. Additionally, the study explored the relationship between FHL and selected variables from SCT.This secondary data analysis was a cross-sectional descriptive study. The sample included 335 individuals living with HIV who were taking antiretroviral medications. Measures of central tendency and variance were used to describe continuous variables. Bivariate analyses and logistic regression were conducted to examine the univariate relationships between and among the key variables of interest. Multivariate logistic regression was used to jointly examine potential predictors of adherence. Overall, 10.4% (n=35) of the participants were classified as having inadequate/marginal FHL. Race, educational level, and the interaction between race and educational level predicted FHL in this sample. Sixty seven percent (n=223) of participants had adherence rates less than 85%, based on days with correct intake. In bivariate analysis, FHL was not significantly related to medication adherence, although there was a non-significant trend suggesting that people with lower FHL may demonstrate lower adherence (÷2 = 3.17, p=.075). FHL was also not related to self-efficacy beliefs. In multivariate logistic regression, non-white participants, people with lower self-efficacy beliefs, and younger individuals were more likely to demonstrate poorer adherence.Using multivariate logistic regression, medication adherence was significantly related to mental health functioning, role of state of mind in controlling illness, negative self-image related to HIV-stigma, and two interaction terms (mental health functioning and negative self-image related to HIV-stigma; personalized stigma and FHL), after controlling for race and age. The proportion of people with lower FHL was lower than expected. Further research is needed to fully understand the scope and breadth of FHL issues for people living with HIV. Further research is needed to understand the disparate findings related to FHL and treatment adherence. Finally, these results indicate that there remains much work to be done in identifying true predictors of medication adherence in people living with HIV.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Colbert, Alison
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairErlen, Judith A.erlen001@pitt.eduERLEN001
Committee MemberSilvestre, Anthonytonys@stophiv.pitt.eduTONYS
Committee MemberBurns, Helenburnsh@pitt.eduBURNSH
Committee Member Burke, Lora E.lbu100@pitt.eduLBU100
Committee MemberSereika, Susanssereika@pitt.eduSSEREIKA
Date: 23 January 2008
Date Type: Completion
Defense Date: 4 December 2007
Approval Date: 23 January 2008
Submission Date: 2 January 2008
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: School of Nursing > Nursing
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: adherence; health literacy; HIV
Other ID:, etd-01022008-153542
Date Deposited: 10 Nov 2011 19:30
Last Modified: 15 Nov 2016 13:35


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