Association between health literacy and complementary and alternative medicine use among African-Americans with AIDS

Background: The use of complementary and alternative medicine (CAM) to treat chronic illnesses, especially Human Immunodeficiency Virus (HIV), is becoming increasingly widespread. Given this popularity, it is important to investigate the predictors of CAM use in this population. The present study examined the relationship between health literacy and CAM use among a sample of African-Americans with Acquired Immune Deficiency Syndrome (AIDS).

Methods: Data were analyzed from 182 individuals who have had an AIDS diagnosis, identified as African-American, were over the age of 21, were receiving their HIV-related care from an infectious disease clinic in a large, public hospital in Atlanta, Georgia and consented to participate in an audio computer-assisted self-interview (ACASI) survey on CAM use. Study participants were classified as either "non/infrequent" or "occasional/frequent" CAM users based on responses to questions about how often they used various CAM therapies. Participants were classified as having high literacy or low literacy based on their scores on The Newest Vital Sign, a 6-item tool intended for identifying individuals at risk for low health literacy in a clinical setting. Logistic regression models, adjusted for potential confounders, were used to investigate the relationship between health literacy and CAM use.

Results: Participants with high health literacy relative to those with low literacy were 8.54 times more likely to use CAM (CI: 3.90-18.70, P < 0.001), even after adjusting for age, sex, and education.

Conclusions: The findings provide preliminary evidence that HIV-positive patients with higher health literacy are more likely to report using CAM therapies compared to patients with lower health literacy. Possible explanations are dicussed.