Health literacy on medication adherence of Antiretroviral therapy among adults living with HIV in Bago township, Myanmar

Abstract

The purpose of this study was to describe the health literacy status on medication adherence of anti-retroviral therapy and examine the factors related to medication adherence among adults living with HIV. This cross-sectional study was conducted with a total of 350 adults living with HIV who were taking antiretroviral therapy at two ART clinics in public and private sectors. The mean age of these adults living with HIV was 39.3 years with 46.3% male and 53.7% female. The prevalence of health literacy was high (60%) and low (40%) on medication adherence among adults living with HIV. As per level, higher scores were found in functional and communicative health literacy than the critical health literacy. The proportion of medication adherence was 80.3% in 30days using Visual Analog Scale (VAS) and 84.4% in 4days using Adult AIDS Clinical Trials Group (AACTG) while non-adherence was 19.7% in VAS and 15.7% in AACGT measures. All three levels of health literacy in multiple logistic analysis, functional and communicative health literacy were significantly associated with medication adherence. Adjusted OR of function health literacy was 3.11(95%CI 1.53-6.33) in VAS and 2.75 (95%CI 1.31-5.79) in AACTG while adjusted OR of communicative health literacy was 3.15(95%CI 1.51-6.59) in VAS and 3.20 (95%CI 1.55-6.59) in AACTG. Likewise, low total health literacy was significantly associated with poor adherence (AOR =3.25, 95%CI 1.20-8.81) in VAS and (AOR=3.10, 95%CI=1.23-7.82) in AACTG respectively. Moreover, last CD4 count (<300 cells/mm3), detected viral load (?1000 copies/ml), and self-efficacy were also redisposing factors for both measurements of medication adherence on antiretroviral therapy. Therefore, to improve the medication adherence a lot of effort is needed such as comprehensive tailored intervention for health literacy and supportive motivation to enable patients to have a better understanding about treatment adherence.