Health literacy is a predictor of HIV/AIDS knowledge.

BACKGROUND AND OBJECTIVES This study's objective was to evaluate the association between health literacy and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) knowledge among patients seen at an inner-city, public hospital urgent care center (UCC). METHODS We used a prospective survey of patients offered an HIV test by their providers during a UCC visit. We measured patients' health literacy level using the Rapid Estimate of Adult Literacy in Medicine (REALM) scale and assessed their HIV/AIDS knowledge using a 22-item questionnaire. RESULTS A total of 372 patients were enrolled. Among participants in this relatively young sample (55% were under the age of 40), 92 (25%) had a REALM score at or below a sixth-grade level, and 122 (33%) did not have a high school diploma. Patients' mean HIV/AIDS knowledge scores differed significantly between patients with inadequate health literacy and those with marginal or adequate health literacy. In multivariate analyses, patients' REALM scores were positively associated with patients' HIV/AIDS knowledge even after adjusting for income, education, and risk perception. CONCLUSIONS These findings demonstrate that HIV/AIDS knowledge is strongly associated with patients' health literacy in this inner-city population. These findings reiterate the need to target HIV prevention strategies toward populations with inadequate health literacy levels and to dispel misconceptions regarding HIV/AIDS that directly influence risk-taking behaviors and health care utilization.