Barriers to HIV/AIDS treatment and treatment adherence among African-American adults with disadvantaged education

Seth C. Kalichman, Sheryl L Catz, Bineetha Ramachandran

Research output: Contribution to journalArticlepeer-review

95 Scopus citations


African Americans are disproportionately affected by acquired immunodeficiency syndrome (AIDS). New treatments that slow the progression of human immunodeficiency virus (HIV) infection offer hope for individuals living with HIV/AIDS, but lack of access to care and poor treatment adherence remain significant obstacles to HIV treatment. This study investigated the association between education literacy to HIV treatment adherence and barriers to care among African Americans living with HIV/AIDS. A community-recruited sample of 85 African-American men and 53 women receiving HIV treatment completed measures of health literacy, health status, treatment adherence, emotional well-being, and barriers to care. Nearly one-third (29%) of the participants had <12 years of education or were functionally illiterate, and those with low-education literacy were less likely to be adherent to HIV medications within the previous two days. Lower-education literacy also was related to reasons for missing medications and barriers to accessing medical care. Individuals of low-education literacy also were more emotionally distressed, lacked social support, and were less optimistic than those with higher education. These results indicate that education and health literacy are important factors in HIV-treatment adherence and access to medical care. Interventions are needed for improving treatment adherence among low-income minorities, and such interventions will need tailoring for individuals with limited reading ability.

Original languageEnglish (US)
Pages (from-to)439-446
Number of pages8
JournalJournal of the National Medical Association
Issue number8
StatePublished - Aug 1999
Externally publishedYes


  • African Americans
  • AIDS
  • HIV

ASJC Scopus subject areas

  • Medicine(all)


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