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