Health literacy of people living with HIV in a rural area in Indonesia: A cross-sectional study.

Elfride I. Sianturi,Md. Atiqul Islam,Dyah A. Perwitasari,Katja Taxis,Sitti N. Soltief,Bas Geboers

doi:10.1111/hsc.13075

Abstract

Indonesia, the fourth most populated country in the world, has experienced a fivefold increase in Human Immunodeficiency Virus (HIV)‐infected individuals since 2001. Little is known about health literacy in people living with HIV (PLHIV) in Indonesia. This study aimed to determine the level of health literacy among PLHIV in Indonesia and assess associations between sociodemographic variables, beliefs about medicines, stigma and health literacy. We conducted a cross‐sectional study using questionnaires in PLHIV in Papua, Indonesia. The short version of the Test of Functional Health Literacy in Adults (S‐TOFHLA), Beliefs about Medicines Questionnaire (BMQ) and HIV stigma scale as well as questions on demographic information were completed by the participants from two hospitals in Papua, Indonesia. In a multivariate logistic regression analysis, we assessed the association between sociodemographic variables, stigma, beliefs about medicine and low health literacy. Overall, 331 participants were included, 62.0% female, 67.0% Papuans. A total of 38.5% of participants had low health literacy. PLHIV with multi‐dose regimen were less likely to have low health literacy than those taking a fixed‐dose combination (OR = 0.51; 95%CI = 0.32–0.82). PLHIV who had social support in medicine‐taking were more likely to have low health literacy (OR = 1.78; 95%CI = 1.07–2.97). More awareness about medication overuse (OR = 1.17; 95%CI = 1.06–1.29) and medication harm (OR = 1.10; 95%CI = 1.01–1.20) were also associated with having low health literacy. Overall, interventions targeting health literacy may be a promising strategy to improve self‐management.

Highlights

Health literacy is increasingly recognised as an important determinant for health and illness behaviour among people living withHuman Immunodeficiency Virus (HIV) (PLHIV) (Gazmarariana et al, 2003; Palumbo, 2015)
We identified 1,305 people, with HIV positive status treated in the two study hospitals since 2006
Our cross-sectional study of people living with HIV (PLHIV) who were on antiretroviral therapy (ART) for at least 6 months in two hospitals in Jayapura showed that one of three PLHIV had low health literacy

Summary

Introduction

Health literacy is increasingly recognised as an important determinant for health and illness behaviour among people living withHIV (PLHIV) (Gazmarariana et al, 2003; Palumbo, 2015). Health literacy is increasingly recognised as an important determinant for health and illness behaviour among people living with. PLHIV have shown that low health literacy is associated with less knowledge about HIV and its treatment, lower medication adherence, and clinical outcomes including higher viral loads (Kalichman et al, 2013; Waldrop-Valverde et al, 2009; Zukoski, Thorburn, & Stroud, 2011), and more hospitalisations (Palumbo, 2015). It is important for health professionals to understand their patient's health literacy when providing care (Raynor, 2012), in tailored counselling for PLHIV where factors like stigma may play a role (Pane et al, 2018). The level of health literacy may be an important factor to be taken into account when developing interventions to improve healthcare (Palumbo, 2015). Little is known about health literacy among PLHIV in developing countries in Asia like Indonesia (Rajah, Hassali, & Murugiah, 2019)

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