Measuring Health Literacy Among People Living with HIV in a Medical University Hospital: A Cross-Sectional Study

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Sitthiphon Bunman
Prakasit Wannapaschaiyong
Narongpon Dumavibhat
Tirathat Virojskulchai
Aphicha Nomsiri
Anan Malarat
Sonthaya Saiyasalee


OBJECTIVES:  The study aimed to evaluate the level of health literacy among people living with HIV. 

MATERIALS AND METHODS: A cross-sectional survey was conducted among HIV-infected adult patients. We recruited 530 adults with HIV patients. The level of health literacy was evaluated with the Thai version of the HIV-HLT.

RESULTS: The participants had an average age of 42.66 ± 11.26 years. The majority of the participants are male (65.8%). 92.6% had straight sexual orientation. 57.6% of participants had been diagnosed with HIV infection for more than five years. 86.6% had a CD4 count of more than 200 cells/cm3, and 68.7% had a viral load of less than 20 copies/ml. Most participants (62.1%) had adequate HIV health literacy. The CD4 count of greater than 200 cells/cm3 and viral load of less than 20 copies/ml were also associated with adequate health literacy. Moreover, participants with no previous history of opportunistic infections within the past six months were associated with adequate HIV health literacy.

CONCLUSION: HIV health literacy is significantly associated with CD4 count and viral load outcomes. Therefore, educating patients about the disease and treatment is crucial in reducing the negative consequences of the disease.


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Bunman S, Wannapaschaiyong P, Dumavibhat N, Virojskulchai T, Nomsiri A, Malarat A, Saiyasalee S. Measuring Health Literacy Among People Living with HIV in a Medical University Hospital: A Cross-Sectional Study. BKK Med J [Internet]. 2023 Sep. 30 [cited 2023 Dec. 7];19(2):111. Available from:
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Liu C, Wang D, Liu C, et al. What is the meaning of health literacy? A systematic review and qualitative synthesis. Fam Med Community Health 2020;8(2):e000351.

Gazmararian JA, Williams MV, Peel J, et al. Health literacy and knowledge of chronic disease. Patient Educ Couns 2003;51(3):267-75.

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

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;12:80.

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 Aquir Immune Defic Syndr 2013;63(1):42-50.

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.

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. AIDS Care 2011;23(11):1505-8.

Pane M, Sianturi EI, Kong YMF, et al. Factors associated with regular counselling attendance of HIV outpatients of a national referral hospital in Jakarta, Indonesia: a cross sectional study. BMC Public Health 2018;18(1):1030.

Davis TC, Wolf MS, Bass PF, 3rd, et al. Literacy and misunderstanding prescription drug labels. Ann Intern Med 2006;145(12):887-94.

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.

Wolf MS, Davis TC, Arozullah A, et al. Relation between literacy and HIV treatment knowledge among patients on HAART regimens. AIDS Care 2005;17(7):863-73.

Waldrop-Valverde D, Osborn CY, Rodriguez A, et al. Numeracy skills explain racial differences in HIV medication management. AIDS Behav 2010;14(4):799-806.

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.

Kalichman SC, Amaral CM, Stearns H, et al. Adherence to antiretroviral therapy assessed by unannounced pill counts conducted by telephone. J Gen Intern Med 2007;22(7):1003-6.

Liu H, Miller LG, Hays RD, et al. A comprehensive evaluation of survey questions for adherence to antiretroviral medications and exploratory analyses for identifying optimal sets of survey questions. AIDS Patient Care STDS 2006;20(11):760-72.

Colbert AM, Sereika SM, Erlen JA. Functional health literacy, medication-taking self-efficacy and adherence to antiretroviral therapy. J Adv Nurs 2013;69(2):295-304.

Bunman S, Khawcharoenporn T, Malarat A, et al. THAI VERSION OF HIV HEALTH LITERACY TEST FOR PEOPLE WITH HIV. SEATROPH 2022;51 (4):498-506.

Lindgren TG, Reyes D, Eller L, et al. Understanding Health Literacy for People Living With HIV: Locations of Learning. J Assoc Nurses AIDS Care 2018;29(2):190-203.

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.

Umpreecha C, Bhalang K, Charnvanich D, et al. Efficacy and safety of topical 0.1% cannabidiol for managing recurrent aphthous ulcers: a randomized controlled trial. BMC Complement Med Ther 2023;23(1):57.

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.

Walker RL, Hong JH, Talavera DC, et al. Health literacy and current CD4 cell count in a multiethnic U.S. sample of adults living with HIV infection. Int J STD AIDS 2018;29(5):498-504.

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.