Health Information Behavior of HIV Positive Adults in the Dominican Republic

The ability of individuals living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) to effectively manage their health is dependent on the successful acquisition and use of health information. This may be particularly challenging in limited resource settings where numerous barriers may prevent people from finding, understanding, and applying the information that could lead to better health management. In this dissertation, I aimed to explore the health information behavior of HIV positive adults attending Clínica de Familia in La Romana, Dominican Republic. Offering free treatment and services to over 1,600 HIV positive adults makes this one of the largest HIV treatment centers in the Dominican Republic. Initially, an integrative review of the literature was conducted to summarize research that has explored the patient-identified information needs of HIV positive adults in Latin America and the Caribbean and to identify predominant health information needs of these individuals. Then, a retrospective chart review of 201 randomly selected medical records, two focus group discussions, and an adapted version of Wilson’s 1996 model of information behavior were used to develop a 64-item survey to assess health information behavior. The survey was administered during 107 individual interviews with HIV positive adults being seen at the Clinic. Participants were mostly female (60%), Dominican (75%), and lived in La Romana (59%). Approximately half of participants (49%) were married or in a serious relationship and about a third (33%) of participants had all or some of high school education or higher. Responses to information behavior survey items indicated that patients might not understand all of the health information they do receive, cultural variations may influence understanding of viral transmission, and that participants had low levels of health literacy. Data obtained through the surveys were further analyzed to identify patient characteristics associated with active health information seeking, higher information processing and more information use. Significantly associated patient characteristics were: having ever cared for someone who was very sick, age, gender, length of time at the clinic, and comorbidities. Providers at the Clinic as well as those working in underserved areas globally may use these results to advance their knowledge of the ways in which HIV positive adults interact with health information. This enhanced understanding can inform communication and health education programs that provide the information patients need to manage their health in a more usable way. Future research should examine what methods can be used to more effectively provide health information to patients living in constrained resource settings with limited educational backgrounds.