| Publication Abstract Display | | Type: Poster | | Title: Health literacy in HIV-associated neurocognitive disorders (HAND). | | Authors: Woods SP, Iudicello JE, Dawson MS, Ghias A, Grant I, and the HNRP Group | | Date: 10-16-2013 | | Abstract:Objective: This study sought to determine the effects of HIV-associated neurocognitive disorders (HAND) on health literacy, which represents the functional and critical competencies involved in accessing, understanding, appraising, and applying health information. Health literacy has clear implications for clinical neuropsychology and the management of chronic infectious disease, but has not been thoroughly investigated in HAND.
Method: Participants included 46 HIV+ individuals classified into persons with (n=17) or without (n=39) HAND, and 15 demographically comparable seronegative comparisons who were matched on oral word reading. Each participant was administered validated measures of health literacy, including the Expanded Numeracy Scale (ENS) and the Newest Vital Sign (NVS), alongside a comprehensive neuromedical and neuropsychological evaluation.
Results: A series of one-way ANOVAs revealed significant omnibus differences in performance on the ENS and NVS measures (ps<0.05), which were driven by poorer performance in the HAND group relative to the seronegatives (ps<0.05; Cohen’s d=0.8 and 0.9), who did not differ from HIV+ individuals without HAND (ps>0.10). Within the HIV+ group, poorer health literacy performance was moderately associated with higher HIV RNA in CSF and with self-reported difficulty managing health care in daily life.
Conclusions: Results demonstrate notable deficits on measures of health literacy in individuals with HAND that are associated with poorer HIV disease outcomes, which is consistent with prior research linking low health literacy to poorer medication management in HIV (Kalechstein et al., 1999). Further research should investigate the specific neurocognitive (e.g., decision-making) mechanisms of health literacy, as such insight may play a critical role in the management of HAND. |
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