Pharmacy Internet Navigation Skills in Older Adults with HIV Disease: Influence of Health Literacy and Association with Medication Management
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A large portion of health-based Internet use for persons with HIV is focused on online pharmacies, which can provide a more anonymous, cheaper and easier alternative to purchasing medications. Pharmacy Internet navigation skills (INS) are an important component of successful online pharmacy use in HIV populations, which may be affected by a multitude of factors, including neuropsychological deficits and low health literacy. The current study aimed to: 1) examine whether health literacy modulates the effects of HIV on pharmacy INS speed and accuracy; and 2) evaluate whether pharmacy INS are related to medication management in persons with HIV disease. Study participants included 98 individuals with HIV infection and 36 seronegatives who completed measures of health literacy, medication management, cognition, and the Test of Online Pharmacy Skills (TOPS). In models adjusting for sociodemographics, neurocognition and internet use and anxiety, there were no main effects of HIV on TOPS and no interaction with health literacy. There was a main effect of health literacy, which showed medium effect size associations with TOPS speed/accuracy irrespective of serostatus. Within the HIV+ subsample, models adjusting for sociodemographics, neurocognition and internet use and anxiety showed no main effects of TOPS speed/accuracy on medication management and no interaction with health literacy. There was a main effect of health literacy, which showed medium effect size associations with medication management. Findings indicate that health literacy plays a major role in online pharmacy navigation but is not synergistic with HIV disease. Future studies are needed to further explore the role of various dimensions of health literacy in online pharmacy navigation in order to better identify possible targets for compensation and remediation.