Background Knowledge of HIV+ patients about their disease and antiretroviral treatment (ART) has been associated with adherence and clinical outcomes.
Purpose To determine the degree of knowledge about disease and treatment in HIV+ patients and to analyse related variables.
Material and methods Observational, cross sectional, descriptive 5 month study. Adult HIV+ patients who were dispensed ART and signed the informed consent were selected. Data collected were sociodemographic (age, gender, nationality, education) and clinical (time on ART, naïve, CD4 count, viral load (VL) and hepatitis C virus (HCV) coinfection). Knowledge about disease/ART was assessed by a 37 item interview regarding HIV mechanism (1), transmission (15), monitoring (5) and treatment (16). Adequate knowledge was considered if >85% of answers were correct with no critical items (13) failed.
Health literacy was evaluated by the SAHL-S questionnaire.
Bivariate analysis was performed to identify variables associated with knowledge: χ2 test for qualitative variables and the Student’s t or the Mann-Whitney U test for quantitative variables.
Results 86 patients were included (80.2% male, 46.7 ± 10.3 years); 86.1% native; 58.1% unschooled.
Mean CD4 was 597.3 ± 229.8; 90.7% undetectable VL; 3.5% naïve. Mean time on ART was 10.9 ± 7.3 years. 48.8% were HCV coinfected.
Mean percentage of correct responses was 84.3 ± 15.9% (97.7 ± 0.2% for mechanism; 92.4 ± 0.1% for transmission; 73.5 ± 0.3% for monitoring; 83.7 ± 0.1% for treatment).
64% patients did not have adequate knowledge. Most common critical errors were: attitude when a pill is missed (40.7%), VL concept (30.2%) and “believe that remove penis before ejaculation prevents transmission” (12.8%). 20.9% thought HIV+ mothers always had HIV+ babies. Regarding transmission, some believed it was possible by mosquitoes (16%), public toilets (8%) and coughing/sneezing or kissing (7%). For 10.5% there is no risk if VL is undetectable. The CD4 concept and monitoring was unknown by 34.9% and 39.5%, respectively. 7% of patients did not know their own ART, adverse reactions (23.3%) or interactions (74,4%).
There was an association between lack of knowledge and age (mean difference=5.91, 95% CI 1.46 to 10.36; p = 0,02) and health literacy (OR=1.67, 95% CI 1.39 to 2.01; p = 0,02). There was a non-significant trend for non-native nationality and self-perception of knowledge.
Conclusion Knowledge about disease and ART is deficient in HIV+ patients. Age and health literacy may be risk factors for a lesser degree of knowledge.
No conflict of interest.
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