Understanding Health Literacy among Bisexual Living with HIV: A Preliminary study

Main Article Content

Sitthiphon Bunman
Prakasit Wannapaschaiyong
Aphicha Nomsir
Anan Malarat
Sonthaya Saiyasalee


OBJECTIVES: This preliminary study aims to evaluate health literacy among bisexual men living with HIV.

MATERIALS AND METHODS: A cross-sectional survey was conducted among 26 adult bisexual male HIV-infected patients in the HIV Clinic from October 2021 to May 2022. We applied the Thai version of the HIV-HLT to investigate health literacy among bisexual men living with HIV.

RESULTS: The average age of the participants was 41.34 ± 12.41 years. 61.5% were single and 34.6% had divorced marital status. 50% had finished their bachelor degrees. Approximately half of the participants had been diagnosed with HIV infection for more than 5 years. 57.7% had adequate HIV health literacy and 26.9% had inadequate HIV health literacy, respectively. The laboratory outcome showed that 96.2% had a CD4 count of more than 200 cells/cm3 and 76.9% had a viral load of less than 20 copies/ ml. CD4 and viral load were not associated with the level of health literacy. However, all participants had no previous history of opportunistic infections within the past 6 months.

CONCLUSION: Most bisexual men living with HIV have adequate health literacy. The level of health literacy is not associated with CD4 and viral load. However, opportunistic infections within the past 6 months are not reported. Therefore, a Thai version of HIV-HLT may be applied to measure health literacy among bisexual men living with HIV and could be a potential for clinical use.

Article Details

How to Cite
Bunman S, Wannapaschaiyong P, Nomsir A, Malarat A, Saiyasalee S. Understanding Health Literacy among Bisexual Living with HIV: A Preliminary study. BKK Med J [Internet]. 2023 Feb. 28 [cited 2024 Feb. 22];19(1):35. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/260900
Original Article


Gazmararian JA, Williams MV, Peel J, et al. Health literacy and knowledge of chronic disease. Patient Educ Couns2003;51(3):267-75. doi: 10.1016/s0738-3991(02)00239-2.

Palumbo R. Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review. Int JHealth Policy Manag 2015;4(7):417-30. doi: 10.15171/ijhpm.2015.95.

Sørensen K, Van den Broucke S, Fullam J, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC public health 2012;12(1):1-13. doi:10.1186/1471-2458-12-80.

Kalichman SC, Cherry C, Kalichman MO, et al. Randomized clinical trial of HIV treatment adherence counseling interventions

for people living with HIV and limited health literacy. J Acquir Immune Defic Syndr 2013;63(1):42-50.

doi: 10.1097/QAI.0b013e318286ce49.

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 and Behavior 2009;13(1):46-52. doi: 10.1007/s10461-008-9425-x.

Zukoski AP, Thorburn S, Stroud J. Seeking information about HIV/AIDS: a qualitative study of health literacy among

people living with HIV/AIDS in a low prevalence context.AIDSCare2011; 23(11):1505-8.

do i :10.1080/09540121.2011.582077.

Davis TC, Wolf MS, Bass PF, et al. Literacy and misunderstanding prescription drug labels. Ann Intern Med 2006;145(12):887-94.

doi: 10.7326/0003-4819-145-12-200612190-00144.

Wawrzyniak AJ, Ownby RL, McCoy K, et al. Health literacy:impact on the health of HIV-infected individuals. Curr HIV/AIDS

Rep 2013;10(4):295-304. doi: 10.1007/s11904-013-0178-4.

Rajah R, Hassali MAA, Murugiah MK. A systematic review of the prevalence of limited health literacy in Southeast Asian

countries. Public Health 2019;167:8-15. doi: 10.1016/j.puhe.2018.09.028.

Reynolds R, Smoller S, Allen A, et al. Health Literacy and Health Outcomes in Persons Living with HIV Disease: A

Systematic Review. AIDS Behav 2019;23(11):3024-43. doi:10.1007/s10461-019-02432-9.

Brookfield S, Dean J, Forrest C, et al. Barriers to Accessing Sexual Health Services for Transgender and Male Sex

Workers: A Systematic Qualitative Meta-summary. AIDS Behav 2020;24(3):682-96. doi: 10.1007/s10461-019-02453-4.

Gilbert M, Michelow W, Dulai J, et al. Provision of online HIV-related information to gay, bisexual and other men who

have sex with men: a health literacy-informed critical appraisal of Canadian agency websites. Sex Health2019;16(1):39-46. doi: 10.1071/SH18092.

Oliffe JL, McCreary DR, Black N, et al. Canadian Men’s Health Literacy: A Nationally Representative Study. Health

PromotPract2020;21 (6):993-1003.doi:10.1177/1524839919837625.

Kalichman SC, Cherry J, Cain D. Nurse-delivered antiretroviral treatment adherence intervention for people with low literacy

skills and living with HIV/AIDS. J Assoc Nurses AIDS Care 2005;16(5):3-15. doi: 10.1016/j.jana.2005.07.001.

Osborn CY, Paasche-Orlow MK, Davis TC, et al. Health literacy: an overlooked factor in understanding HIV health

disparities. Am J Prev Med 2007;33(5):374-8. doi: 10.1016/j.amepre.2007.07.022.

Wolf MS, Davis TC, Osborn CY, et al. Literacy, self-efficacy,and HIV medication adherence. Patient Educ Couns

;65(2):253-60. doi: 10.1016/j.pec.2006.08.006.

Baker DW, Williams MV, Parker RM, et al. Development of a brief test to measure functional health literacy. Patient Educ

Couns 1999;38(1):33-42. doi: 10.1016/s0738-3991(98)00116-5.

Osborn CY, Davis TC, Bailey SC, et al. Health literacy in the context of HIV treatment: introducing the Brief Estimate of

Health Knowledge and Action (BEHKA)-HIV version. AIDS Behav 2010;14(1):181-8. doi: 10.1007/s10461-008-9484-z.

Bunman S, Khawcharoenporn T, Malarat A, VatcharavongvanP. THAI VERSION OF HIV HEALTH LITERACY TEST

FOR PEOPLE WITH HIV. SEATROPH 2022:51(4):498-506.

Tique JA, Howard LM, Gaveta S, et al. Measuring Health Literacy Among Adults with HIV Infection in Mozambique:

Development and Validation of the HIV Literacy Test. AIDS Behav 2017;21(3):822-32. doi: 10.1007/s10461-016-1348-3.