HIV Treatment Adherence, Patient Health Literacy, and Health Care Provider–Patient Communication

Abstract

Background: Little is known about patients' health literacy regarding antiretroviral therapy (ART) adherence and drug resistance and patient–provider communication about these topics. Design and Methods: The AIDS Treatment for Life International Survey was a multicountry cross-sectional study (January-March 2010) including 2035 HIV-infected adults. A 40-minute interview was conducted using a standardized self-report adherence questionnaire. Results: Overall, 57% of patients reported a 30-day recall of 100% adherence (Latin America: 89%; Africa: 73% vs North America: 45% and Asia Pacific: 47%; P < .01). Overall, 18% identified HIV drug resistance as a “good thing” in North America (35%) and Africa (24%). Only 71% said their health care providers had offered practical recommendations about adherence, 62% of the patients in North America and 80% in Latin America and Africa. Conclusions: Optimal ART adherence remains a challenge globally. There is a critical need to improve patient–provider communication about the importance of ART adherence and its benefits for patient’s health.