A Systematic Review of Factors Critical for HIV Health Literacy, ART Adherence and Retention in Care in the U.S. for Racial and Ethnic Minorities

Despite advances in antiretroviral treatment (ART), the HIV epidemic persists in the United States (U.S.), with inadequate adherence to treatment and care a major barrier to ending the epidemic. Health literacy is a critical factor in maximizing ART adherence and healthcare utilization, especially among vulnerable populations, including racial and ethnic minorities. This U.S-based systematic review examines psychosocial variables influencing health literacy among persons with HIV (PWH), with a focus on racial and ethnic minorities. Although findings are limited, some studies showed that HIV-related stigma, self-efficacy, and patient trust in providers mediate the relationship between health literacy and both ART adherence and HIV care retention. To inform effective, equitable health literacy interventions to promote adherence to HIV treatment and care, further research is needed to understand the factors driving the relationship between health literacy and HIV outcomes. Such work may broaden our understanding of health literacy in the context of racial equity.