We examined the relationship of patients’ literacy and education to antiretroviral therapy (ART) adherence in an
urban treatment centre in The Gambia. Information on education and literacy systematically collected before
ART initiation was compared against selected adherence outcomes.
Formally educated patients were significantly more likely to achieve virological suppression at both six and
12 months (87% vs. 67%, OR3.13, P0.03; 88% vs. 63%, OR4.49, P0.007, respectively). Literate
patients had similar benefit at 12 months (OR3.39 P0.03), with improved virological outcomes associated
with degree of literacy (P0.003). A trend towards similar results was seen at 6 months for Koranically educated
patients; however, this was no longer apparent at 12 months. No significant correlation was seen between sociodemographic
characteristics and missed appointments.
Our study suggests that literacy, formal education and possibly Koranic education may impact favourably on
adherence to ART