Relation of health literacy to gonorrhoea related care

Objective: To assess the relation between health literacy and receipt of a screening test for gonorrhoea in the past year. Methods: Study design was multisite, cross sectional survey of subjects enr olled from clinics, from community based organisations, and by street inter cept. Data were obtained using face to face interview. The dependent variab le was self reported receipt of a test for gonorrhoea in the past year. Hea lth literacy was measured by the Rapid Estimate of Adult Literacy in Medici ne (REALM), recoded to represent 8th grade or lower reading or 9th grade an d higher reading level. Statistical analyses were adjusted to account for s election bias in literacy assessment. Results: 54% of the sample reported at least one gonorrhoea test in the pre vious year. 65% of the sample read at a 9th grade level or higher. REALM sc ore was moderately correlated with the respondent's years of education. Aft er adjustment for missing REALM data, past suspicion of gonorrhoea, self in spection for gonorrhoea, self efficacy for care seeking, REALM score of 9th grade reading level or higher, and younger age were independently associat ed with gonorrhoea testing in the previous year. For the average respondent , REALM reading grade level of 9th grade or higher is associated with a 10% increase in the probability of having a gonorrhoea test in the past year. Conclusions: Low literacy appears to pose a barrier to care for sexually tr ansmitted infections such as gonorrhoea.