Aspects related to health literacy, self-care and compliance with treatment of people living with HIV

Silva, Mônica Alice Santos da; Lima, Morgana Cristina Leôncio de; Dourado, Cynthia Angélica Ramos Oliveira; Andrade, Maria Sandra

doi:10.1590/1980-220X-REEUSP-2022-0120en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 56 • 2022 • https://doi.org/10.1590/1980-220X-REEUSP-2022-0120en copy

Aspects related to health literacy, self-care and compliance with treatment of people living with HIV^* * Extracted from the dissertation “Alfabetização em saúde de pessoas vivando com o vírus da imunodeficiência humana”, Universidade de Pernambuco/Universidade Estadual de Paraíba, 2019.

Aspectos relacionados ao letramento em saúde, autocuidado e adesão ao tratamento de pessoas vivendo com HIV

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to verify the relationship between health literacy, compliance with antiretroviral therapy and self-care of people living with HIV.

Method:

this is a cross-sectional study, developed between January and July 2019, using validated scales on health literacy (SAHLPA), compliance (CEAT-HIV) and self-care (EACAC).

Results:

a total of 303 people enrolled in three HIV outpatient care services participated in the study, with a satisfactory level of literacy (52.5%), excellent level of self-care (62.9%) and strict compliance with antiretroviral therapy (57.1%). The illiterate had insufficient medication compliance, when compared with the literate (PR = 1.17). Strict compliance was significant for self-care (p-value < 0.001). A higher risk ratio for illiteracy was associated with females, people with elementary education, who receive benefits, with an income of up to one minimum wage, not having the habit of seeking health information and longer use of ART.

Conclusion:

a relationship was identified between literacy and insufficient compliance. The risk for insufficient medication compliance increases as self-care declines. Social measures that reduce inequities can contribute to improving care for people living with HIV.

DESCRIPTORS
Health Literacy; Medication Adherence; Self Care; Nursing; HIV

Factor assessed	n	%	p-value
Sex
Male	197	65.0	<0.001¹
Female	106	35.0	<0.001¹
Age
≤ 40	109	36.0	<0.001¹
41–59	169	55.8	<0.001¹
≥60	25	8.2
Minimum–maximum	20–74
Mean ± standard deviation	44.16 ± 10.97
Education level
Elementary school	104	34.7	<0.001¹
High school	140	46.7
Higher education/graduate degree	56	18.6
Marital status
Single	157	51.8	<0.001¹
Married	65	21.5
Widow	27	8.9
Separated	21	6.9
Stable union	33	10.9
Ethnicity
White	72	23.8	<0.001¹
Black	59	19.5
Brown	162	53.5
Others	10	3.3
Occupation
Employed	114	37.6	<0.001¹
Unemployed	65	21.5
Studying	17	5.6
Retired	36	11.9
Benefit	71	23.4
Income
Up to 1 minimum wage	238	79.1	<0.001¹
≥ 2 minimum wages	63	20.9	<0.001¹

Factor assessed	Compliance		PR*	(95%) CI**	p–value
Factor assessed	Insufficient	Strict	PR*	(95%) CI**	p–value
Literacy
Illiterate	67(46.5%)	77(53.5%)	1.17	0.91–1.52	0.225¹
Literate	63(39.6%)	96(60.4%)	1.00	–	0.225¹
Self–care
Good	22(75.9%)	7(24.1%)	2.23	1.67–2.97	<0.001 ¹
Very good	42(51.2%)	40(48.8%)	1.50	1.13–2.01
Great	64(34.0%)	124(66.0%)	1.00	–

Literacy level	Self–care			p–value
Literacy level	Good	Very good	Great	p–value
Illiterate	18(12.8%)	37(26.2%)	86(61.0%)	0.238¹
Literate	11(6.9%)	45(28.5%)	102(64.6%)	0.238¹

Factor assessed	Literacy		PR*	(95%) CI**	p-value
Factor assessed	Illiterate	Literate	PR*	(95%) CI**	p-value
Age
≤ 40	44(40.4%)	65(59.6%)	1.00	–	0.125¹
41–59	89(52.7%)	80(47.3%)	1.30	1.00–1.71
≥60	11(44.0%)	14(56.0%)	1.09	0.66–1.79
Sex
Male	83(42.1%)	114(57.9%)	1.00	–	0.010 ¹
Female	61(57.5%)	45(42.5%)	1.37	1.08–1.72	0.010 ¹
Education level
Elementary school	86(82.7%)	18(17.3%)	15.44	5.12–46.58	<0.001 ¹
High school	52(37.1%)	88(62.9%)	6.96	2.26–21.29
Higher education/graduate degree	l3(5.4%)	53(94.6%)	1.00	–
Marital status
Single	71(45.2%)	86(54.8%)	1.01	0.74–1.40	0.653¹
Married	29(44.6%)	36(55.4%)	1.00	–
Widow	16(59.3%)	11(40.7%)	1.33	0.88–2.01
Separated	11(52.4%)	10(47.6%)	1.17	0.72–1.92
Stable union	17(51.5%)	16(48.5%)	1.15	0.75–1.77
Ethnicity
White	31(43.1%)	41(56.9%)	1.00	–	0.357¹
Black	34(57.6%)	25(42.4%)	1.34	0.95–1.89
Brown	74(45.7%)	88(54.3%)	1.06	0.77–1.45
Others	5(50.0%)	5(50.0%)	1.16	>0.59–2.28
Occupation
Employed	34(29.8%)	80(70.2%)	5.07	0.74–34.66	<0.001 ¹
Unemployed	34(52.3%)	31(47.7%)	8.89	1.31–60.39
Studying	1(5.9%)	16(94.1%)	1.00	–
Retired	22(61.1%)	14(38.9%)	10.39	1.52–70.81
Benefit	53(74.6%)	18(25.4%)	12.69	1.89–85.38
Income
Up to 1 minimum wage	129(54.2%)	109(45.8%)	2.28	1.44–3.59	<0.001 ¹
≥ 2 minimum wages	15(23.8%)	48(76.2%)	1.00	–	<0.001 ¹

Factor assessed	Literacy		PR*	(95%) CI**	p-value
Factor assessed	Illiterate	Literate	PR*	(95%) CI**	p-value
Controlled medication use
Yes	27(52.9%)	24(47.1%)	1.14	0.85–1.53	0.396¹
No	117(46.4%)	135(53.6%)	1.00	–	0.396¹
Interruption of ART*
Yes	50(54.9%)	41(45.1%)	1.25	0.98–1.59	0.081¹
No	92(44.0%)	117(56.0%)	1.00	–	0.081¹
Search for information
Yes	108(43.5%)	140(56.5%)	1.00	–	0.003 ¹
No	36(65.5%)	19(34.5%)	1.50	1.18–1.91	0.003 ¹
ART use time
6 months to 5 years	48(39.0%)	75(61.0%)	1.00	–	0.017 ¹
6 to 10 years	47(59.5%)	32(40.5%)	1.52	1.15–2.03
> 10 years	49(48.5%)	52(51.5%)	1.24	0.92–1.68

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Mônica Alice Santos da Silva Rua Arnóbio Marques, 310, Santo Amaro 50.100-130 – Recife, PE, Brasil monica.alice@upe.br

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Aspects related to health literacy, self-care and compliance with treatment of people living with HIV* * Extracted from the dissertation “Alfabetização em saúde de pessoas vivando com o vírus da imunodeficiência humana”, Universidade de Pernambuco/Universidade Estadual de Paraíba, 2019.

Aspectos relacionados ao letramento em saúde, autocuidado e adesão ao tratamento de pessoas vivendo com HIV

ABSTRACT

Objective:

Method:

Results:

Conclusion:

Aspects related to health literacy, self-care and compliance with treatment of people living with HIV^* * Extracted from the dissertation “Alfabetização em saúde de pessoas vivando com o vírus da imunodeficiência humana”, Universidade de Pernambuco/Universidade Estadual de Paraíba, 2019.