Requesting help to understand medical information among people living with HIV and poor health literacy.

Health literacy is known to influence medication adherence among people living with HIV/AIDS. People who experience difficulty reading health information may benefit from asking others to assist them with reading, interpreting, and understanding medical information. We examined medical chart-abstracted HIV viral load, medication adherence assessed by unannounced pill counts, and adherence improvement strategies among 245 individuals with lower-health literacy who do not request assistance, and 229 who do request assistance with reading and understanding health information. Participants were people living with HIV who were taking antiretroviral therapy and scored below 90% correct on a standardized test of functional health literacy. After controlling for health literacy scores, requesting informational assistance was associated with strategies used to improve adherence; individuals who asked for assistance were significantly more likely to use multiple adherence strategies. However, despite requesting informational assistance and using more adherence strategies, participants who requested informational assistance evidenced poorer treatment adherence and poorer suppression of HIV replication. Requesting assistance was more common among those with the poorest health literacy and therefore greatest challenges to adherence. People living with HIV who have poor health literacy skills may benefit from medication adherence programs and requests for assistance afford opportunities for social interventions.