Skip to main content
Top
Published in: AIDS and Behavior 4/2010

01-08-2010 | Original Paper

Numeracy Skills Explain Racial Differences in HIV Medication Management

Authors: Drenna Waldrop-Valverde, Chandra Y. Osborn, Allan Rodriguez, Russell L. Rothman, Mahendra Kumar, Deborah L. Jones

Published in: AIDS and Behavior | Issue 4/2010

Login to get access

Abstract

Racial disparities in HIV/AIDS are well established and efforts to understand key factors that may explain these differences are needed. Recent evidence suggests that health literacy may contribute to disparities in health behaviors among African American HIV patients. One component of health literacy, numeracy, is emerging as an important skill for successful self management of medications. We therefore tested whether numeracy mediated the effects of race on medication management among HIV seropositive patients. Results showed that poor management of a simulated HIV medication regimen among African Americans and women was mediated by lower numeracy. Poor medication self-management may be a significant root cause for health disparities in African Americans with HIV/AIDS. Whether African American women may be at particular risk requires further study. Interventions to improve HIV medication self-management through addressing numeracy skills may help to narrow the gap in health disparities among African Americans with HIV/AIDS.
Literature
1.
go back to reference CDC. HIV/AIDS surveillance report, Vol. 17, Rev. ed. US Department of Health and Human Services; 2007. CDC. HIV/AIDS surveillance report, Vol. 17, Rev. ed. US Department of Health and Human Services; 2007.
2.
go back to reference Fullilove RE. African Americans, health disparities and HIV/AIDS—recommendations for confronting the epidemic in Black America. Washington, DC: National Minority AIDS Council; 2006. Fullilove RE. African Americans, health disparities and HIV/AIDS—recommendations for confronting the epidemic in Black America. Washington, DC: National Minority AIDS Council; 2006.
3.
go back to reference Sudore RL, Yaffe K, Satterfield S, et al. Limited literacy and mortality in the elderly: the health, aging, and body composition study. J Gen Intern Med. 2006;21(8):806–12.CrossRefPubMed Sudore RL, Yaffe K, Satterfield S, et al. Limited literacy and mortality in the elderly: the health, aging, and body composition study. J Gen Intern Med. 2006;21(8):806–12.CrossRefPubMed
4.
go back to reference Kalichman SC, Benotsch E, Suarez T, et al. Health literacy and health-related knowledge among persons living with HIV/AIDS. Am J Prev Med. 2000;18(4):325–31.CrossRefPubMed Kalichman SC, Benotsch E, Suarez T, et al. Health literacy and health-related knowledge among persons living with HIV/AIDS. Am J Prev Med. 2000;18(4):325–31.CrossRefPubMed
5.
go back to reference Kalichman SC, Rompa D. Functional health literacy is associated with health status and health-related knowledge in people living with HIV-AIDS. J Acquir Immune Defic Syndr. 2000;25(4):337–44.CrossRefPubMed Kalichman SC, Rompa D. Functional health literacy is associated with health status and health-related knowledge in people living with HIV-AIDS. J Acquir Immune Defic Syndr. 2000;25(4):337–44.CrossRefPubMed
6.
go back to reference Arnsten JH, Demas PA, Grant RW, et al. Impact of active drug use on antiretroviral therapy adherence and viral suppression in HIV-infected drug users. J Gen Intern Med. 2002;17(5):377–81.PubMed Arnsten JH, Demas PA, Grant RW, et al. Impact of active drug use on antiretroviral therapy adherence and viral suppression in HIV-infected drug users. J Gen Intern Med. 2002;17(5):377–81.PubMed
7.
go back to reference Miller LG, Liu H, Hays RD, et al. Knowledge of antiretroviral regimen dosing and adherence: a longitudinal study. Clin Infect Dis. 2003;36(4):514–8.CrossRefPubMed Miller LG, Liu H, Hays RD, et al. Knowledge of antiretroviral regimen dosing and adherence: a longitudinal study. Clin Infect Dis. 2003;36(4):514–8.CrossRefPubMed
8.
go back to reference Stone VE, Hogan JW, Schuman P, et al. Antiretroviral regimen complexity, self-reported adherence, and HIV patients’ understanding of their regimens: survey of women in the her study. J Acquir Immune Defic Syndr. 2001;28(2):124–31.CrossRefPubMed Stone VE, Hogan JW, Schuman P, et al. Antiretroviral regimen complexity, self-reported adherence, and HIV patients’ understanding of their regimens: survey of women in the her study. J Acquir Immune Defic Syndr. 2001;28(2):124–31.CrossRefPubMed
9.
go back to reference Osborn CY, Paasche-Orlow MK, Davis TC, Wolf MS. Health literacy: an overlooked factor in understanding HIV health disparities. Am J Prev Med. 2007;33(5):374–8.CrossRefPubMed Osborn CY, Paasche-Orlow MK, Davis TC, Wolf MS. Health literacy: an overlooked factor in understanding HIV health disparities. Am J Prev Med. 2007;33(5):374–8.CrossRefPubMed
10.
go back to reference MacLaughlin EJ, Raehl CL, Treadway AK, et al. Assessing medication adherence in the elderly: which tools to use in clinical practice? Drugs Aging. 2005;22(3):231–55.CrossRefPubMed MacLaughlin EJ, Raehl CL, Treadway AK, et al. Assessing medication adherence in the elderly: which tools to use in clinical practice? Drugs Aging. 2005;22(3):231–55.CrossRefPubMed
11.
go back to reference Kripalani S, Henderson LE, Chiu EY, et al. Predictors of medication self-management skill in a low-literacy population. J Gen Intern Med. 2006;21(8):852–6.CrossRefPubMed Kripalani S, Henderson LE, Chiu EY, et al. Predictors of medication self-management skill in a low-literacy population. J Gen Intern Med. 2006;21(8):852–6.CrossRefPubMed
12.
go back to reference Wolf MS, Davis TC, Shrank W, et al. To err is human: patient misinterpretations of prescription drug label instructions. Patient Educ Couns. 2007;67(3):293–300.CrossRefPubMed Wolf MS, Davis TC, Shrank W, et al. To err is human: patient misinterpretations of prescription drug label instructions. Patient Educ Couns. 2007;67(3):293–300.CrossRefPubMed
13.
go back to reference Davis TC, Wolf MS, Bass PFIII, et al. Low literacy impairs comprehension of prescription drug warning labels. J Gen Intern Med. 2006;21(8):847–51.CrossRefPubMed Davis TC, Wolf MS, Bass PFIII, et al. Low literacy impairs comprehension of prescription drug warning labels. J Gen Intern Med. 2006;21(8):847–51.CrossRefPubMed
14.
go back to reference Davis TC, Wolf MS, Bass PFIII, et al. Literacy and misunderstanding prescription drug labels. Ann Intern Med. 2006;145(12):887–94.PubMed Davis TC, Wolf MS, Bass PFIII, et al. Literacy and misunderstanding prescription drug labels. Ann Intern Med. 2006;145(12):887–94.PubMed
15.
go back to reference Rothman RL, Housam R, Weiss H, et al. Patient understanding of food labels: the role of literacy and numeracy. Am J Prev Med. 2006;31(5):391–8.CrossRefPubMed Rothman RL, Housam R, Weiss H, et al. Patient understanding of food labels: the role of literacy and numeracy. Am J Prev Med. 2006;31(5):391–8.CrossRefPubMed
16.
go back to reference Waldrop-Valverde D, Jones DL, Jayaweera D, et al. Gender differences in medication management capacity in HIV infection: the role of health literacy and numeracy. AIDS Behav. 2009;13(1):46–52.CrossRefPubMed Waldrop-Valverde D, Jones DL, Jayaweera D, et al. Gender differences in medication management capacity in HIV infection: the role of health literacy and numeracy. AIDS Behav. 2009;13(1):46–52.CrossRefPubMed
17.
go back to reference Golbeck AL, Ahlers-Schmidt CR, Paschal AM, Dismuke SE. A definition and operational framework for health numeracy. Am J Prev Med. 2005;29(4):375–6.CrossRefPubMed Golbeck AL, Ahlers-Schmidt CR, Paschal AM, Dismuke SE. A definition and operational framework for health numeracy. Am J Prev Med. 2005;29(4):375–6.CrossRefPubMed
18.
go back to reference Cavanaugh K, Huizinga MM, Wallston KA, et al. Association of numeracy and diabetes control. Ann Intern Med. 2008;148(10):737–46.PubMed Cavanaugh K, Huizinga MM, Wallston KA, et al. Association of numeracy and diabetes control. Ann Intern Med. 2008;148(10):737–46.PubMed
19.
go back to reference Estrada CA, Martin-Hryniewicz M, Peek BT, Collins C, Byrd JC. Literacy and numeracy skills and anticoagulation control. Am J Med Sci. 2004;328(2):88–93.CrossRefPubMed Estrada CA, Martin-Hryniewicz M, Peek BT, Collins C, Byrd JC. Literacy and numeracy skills and anticoagulation control. Am J Med Sci. 2004;328(2):88–93.CrossRefPubMed
20.
go back to reference Woodcock R, McGrew K, Mather N. Woodcock Johnson III tests of achievement. Itasca, IL: Riverside; 2001. Woodcock R, McGrew K, Mather N. Woodcock Johnson III tests of achievement. Itasca, IL: Riverside; 2001.
21.
go back to reference Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med. 1995;10(10):537–41.CrossRefPubMed Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med. 1995;10(10):537–41.CrossRefPubMed
22.
go back to reference Taylor WS. Cloze procedure: a new test for measuring readability. Journal Q. 1953;38:632–7. Taylor WS. Cloze procedure: a new test for measuring readability. Journal Q. 1953;38:632–7.
23.
go back to reference Albert SM, Weber CM, Todak G, et al. An observed performance test of medication management ability in HIV: relation to neuropsychological status and medication adherence outcomes. AIDS Behav. 1999;3(2):121–8.CrossRef Albert SM, Weber CM, Todak G, et al. An observed performance test of medication management ability in HIV: relation to neuropsychological status and medication adherence outcomes. AIDS Behav. 1999;3(2):121–8.CrossRef
24.
go back to reference Ridgon E. CFI versus RMSEA: comparison of two fit indexes for structural equations modeling. Struct Equ Model. 1996;3:369–79.CrossRef Ridgon E. CFI versus RMSEA: comparison of two fit indexes for structural equations modeling. Struct Equ Model. 1996;3:369–79.CrossRef
25.
go back to reference Kline R. Principles and practice of structural equation modeling. New York: Guilford; 2004. Kline R. Principles and practice of structural equation modeling. New York: Guilford; 2004.
26.
go back to reference Loehlin JC. Latent variable models: an introduction to factor, path, and structural analysis. Hillsdale, NJ: Lawrence Erlbaum; 1992. Loehlin JC. Latent variable models: an introduction to factor, path, and structural analysis. Hillsdale, NJ: Lawrence Erlbaum; 1992.
27.
go back to reference IOM. Health literacy: a prescription to end confusion. Washington, DC; 2004. IOM. Health literacy: a prescription to end confusion. Washington, DC; 2004.
28.
go back to reference Osborn CY, Cavanaugh K, Wallston KA, White RO, Rothman RL. Diabetes numeracy mediates the association between African American race and poor glycemic control. Diabetes Care. 2009, in press. Osborn CY, Cavanaugh K, Wallston KA, White RO, Rothman RL. Diabetes numeracy mediates the association between African American race and poor glycemic control. Diabetes Care. 2009, in press.
29.
go back to reference Grant I, Atkinson JH, Hesselink JR, et al. Evidence for early central nervous system involvement in the acquired immunodeficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) infections. Studies with neuropsychologic testing and magnetic resonance imaging. Ann Intern Med. 1987;107(6):828–36.PubMed Grant I, Atkinson JH, Hesselink JR, et al. Evidence for early central nervous system involvement in the acquired immunodeficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) infections. Studies with neuropsychologic testing and magnetic resonance imaging. Ann Intern Med. 1987;107(6):828–36.PubMed
30.
go back to reference Martin EM, Robertson LC, Edelstein HE, et al. Performance of patients with early HIV-1 infection on the Stroop Task. J Clin Exp Neuropsychol. 1992;14(5):857–68.CrossRefPubMed Martin EM, Robertson LC, Edelstein HE, et al. Performance of patients with early HIV-1 infection on the Stroop Task. J Clin Exp Neuropsychol. 1992;14(5):857–68.CrossRefPubMed
31.
go back to reference Peavy G, Jacobs D, Salmon DP, et al. Verbal memory performance of patients with human immunodeficiency virus infection: evidence of subcortical dysfunction. The HNRC Group. J Clin Exp Neuropsychol. 1994;16(4):508–23.CrossRefPubMed Peavy G, Jacobs D, Salmon DP, et al. Verbal memory performance of patients with human immunodeficiency virus infection: evidence of subcortical dysfunction. The HNRC Group. J Clin Exp Neuropsychol. 1994;16(4):508–23.CrossRefPubMed
32.
go back to reference Wilkie FL, Goodkin K, van Zuilen MH, et al. Cognitive effects of HIV-1 infection. CNS Spectr. 2000;5(5):33–51.PubMed Wilkie FL, Goodkin K, van Zuilen MH, et al. Cognitive effects of HIV-1 infection. CNS Spectr. 2000;5(5):33–51.PubMed
33.
go back to reference Waldrop-Valverde D, Rodriguez A, Ownby RL. Health literacy and medication management among HIV positive African Americans. NIH Summit: The Science of Eliminating Health Disparities. National Harbor, MD; 2008. Waldrop-Valverde D, Rodriguez A, Ownby RL. Health literacy and medication management among HIV positive African Americans. NIH Summit: The Science of Eliminating Health Disparities. National Harbor, MD; 2008.
34.
go back to reference Chesney MA. Factors affecting adherence to antiretroviral therapy. Clin Infect Dis. 2000;30(Suppl 2):S171–6.CrossRefPubMed Chesney MA. Factors affecting adherence to antiretroviral therapy. Clin Infect Dis. 2000;30(Suppl 2):S171–6.CrossRefPubMed
Metadata
Title
Numeracy Skills Explain Racial Differences in HIV Medication Management
Authors
Drenna Waldrop-Valverde
Chandra Y. Osborn
Allan Rodriguez
Russell L. Rothman
Mahendra Kumar
Deborah L. Jones
Publication date
01-08-2010
Publisher
Springer US
Published in
AIDS and Behavior / Issue 4/2010
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-009-9604-4

Other articles of this Issue 4/2010

AIDS and Behavior 4/2010 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.