Measuring Health Literacy among People Living with HIV who attend a Community-Based Ambulatory Clinic in Puerto Rico

Objective: Health literacy is an important area for interventions aimed at reducing or eliminating the health disparities of people living with HIV (PLWH). We sought to determine the level of functional health literacy (FHL) and its association with medication adherence, symptoms, and their attendant management strategies in PLWH. Methods: This was a cross-sectional study conducted with 200 adults from a community-based ambulatory clinic in San Juan, Puerto Rico. Results: The mean age of the participants was 46.61. Almost half of all participants (47%) had marginal or inadequate levels of health literacy (21.5%, n = 23; 25.50%, n = 51, respectively). Educational level, being employed, annual income, having children, incorrect self-reported CD4+T cell counts, were they actually reported their viral loads, adherence to antiretroviral treatment (ART), and use of self-care strategies for depression were significantly related to a given individual's level of health literacy (p<0.05). Significant interactions were found between adherence and FHL (p = 0.0069). People with marginal health literacy had a higher mean score (1.77 +/- 937) on the adherence scale than did those with inadequate literacy levels. After adjusting for age, education, and the number of people per room at the participant's home, data showed that for those who were 45 years of age or younger, there were significant differences (p = 0.002) in the mean scores of the adherence scale between those with marginal levels of health literacy and those who had inadequate levels of same (5.66 +/- 1.84). Conclusion: Findings from this study fill an existing gap in the important area of health literacy among PLWH in Puerto Rico and highlight the importance of conducting future research geared towards incorporating FHL as an essential component in the management of adherence as well as in both symptoms and the management of same in PLWH.