This study examined the relationship between health literacy, attitudes, and beliefs related to HIV testing among African Americans. The authors hypothesized that higher health literacy would predict more positive attitudes toward HIV testing, even after controlling for other factors. They surveyed 172 African Americans and found that higher health literacy significantly predicted more positive testing attitudes. Prior HIV testing, religious importance, views of HIV as a gay disease, and beliefs about condoms also impacted testing attitudes. The authors concluded that interventions should address multiple factors beyond just self-efficacy to help reduce health disparities.

1. Know Your Status: Health Literacy,
Attitudes, and Beliefs Among African
Americans Towards HIV Testing
R.V. Rikard E. Charles Gagum
Department of Sociology & Department of Sociology &
Anthropology North Carolina Anthropology North Carolina
State University State University
rvrikard@ncsu.edu ecgagum@ncsu.edu
Presented at the 2010 Southern Sociological
Society Meeting
Atlanta, GA
5/19/2010 1

2. Defining Health Literacy
• An individuals’ ability to obtain, process, and
understand health information to make informed
decisions about their health.
-Institute of Medicine (2004)
• The degree to which individuals have the capacity
to obtain, process, and understand basic health
information and services needed to make
appropriate health decisions.
-Health People 2010
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3. Context of Health Literacy
Minorities, Men, Elderly, Socioeconomic
Status, Self-Efficacy, Education*
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4. Health Literacy & HIV/AIDS
Four Clinical Studies
Authors Outcome HL Measure
Kalichman, Highly Active Test of Functional
Ramachandra, and Catz Antiretroviral Therapy Health Literacy for
(1999) (HAART) drug Adults (TOFHLA)
Adherence
Barragan and colleagues Acceptance of HIV Rapid Estimate of
(2004) Testing Adult Literacy in
Medicine (REALM)
Hicks et al. (2006) HIV/AIDS knowledge REALM
Mayben and colleagues Delayed HIV Testing TOFHLA
(2007)*
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5. The Present Research
Purpose:
Examine the relationship between health literacy,
attitudes and beliefs related to protective sexual
behavior and HIV testing among a non-clinical sample
of African Americans.
Hypotheses:
1) Controlling for social characteristics and personal resources, health
literacy has a direct and significant effect on HIV testing.
2) Prior HIV testing has a direct impact on the respondents’ attitudes
toward HIV testing.
3) Conservatism and beliefs related to condom use directly impact HIV
testing attitudes.
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6. Measures
DV: Attitude toward HIV Testing
1) I don't know where to go to get tested.
2) I don't know about the costs of getting tested.
3) I have never thought about getting tested.
4) I don't see a need to get tested because I am not at risk.
5) Getting tested would make me look sexually promiscuous.
Reverse Coded
Higher values = Greater level of agreement
with statement. Alpha = 0.67
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7. OLS Regression Models
Model
1 2 3 4 5
Varaible Name
Social Characteristics
Health Literacy -0.740 *** -0.610 *** -0.518 *** -0.523 *** -0.496 ***
Sex -0.378 -0.349 -0.394 -0.172 0.092
Age -0.006 0.003 0.000 0.001 -0.002
Personal Resources
Self-Efficacy -0.996 *** -0.995 ** -1.456 *** -1.353 ***
Education -0.045 -0.035 -0.069 -0.055
Control
HIV Testing -1.658 *** -1.699 *** -1.856 ***
Conservatism
Religious Importance 0.509 0.330
HIV Gay Disease -1.382 *** -1.299 ***
Condom Beliefs
Embarrassing 0.938 ***
Protection 0.127
Model F 7.72 *** 6.6 *** 7.9 *** 10.12 *** 9.89 ***
Adjusted R2 0.137 0.181 0.246 0.365 0.412
*Source: Community and Health Disparity Project, (N=172).. **p>.01;***p>.001
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8. Implications
Targeting only self-efficacy is unlikely to
reduce literacy-related disparities in health
related outcomes (DeWalt, Boone, and
Pigone, 2007).
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9. Know Your Status: Health Literacy,
Attitudes, and Beliefs Among African
Americans Towards HIV Testing
R.V. Rikard E. Charles Gagum
Department of Sociology & Department of Sociology &
Anthropology North Carolina Anthropology North Carolina
State University State University
rvrikard@ncsu.edu ecgagum@ncsu.edu
Presented at the 2010 Southern Sociological
Society Meeting
Atlanta, GA
5/19/2010 9