Original Paper

AIDS and Behavior

, Volume 15, Issue 4, pp 832-841

Substance Use and the Quality of Patient-Provider Communication in HIV Clinics

  • P. Todd KorthuisAffiliated withDivision of General Internal Medicine and Geriatrics, Oregon Health & Science UniversityDepartment of Public Health and Preventive Medicine, Oregon Health & Science University Email author 
  • , Somnath SahaAffiliated withDivision of General Internal Medicine and Geriatrics, Oregon Health & Science UniversityDepartment of Public Health and Preventive Medicine, Oregon Health & Science UniversitySection of General Internal Medicine, Portland VA Medical Center
  • , Geetanjali ChanderAffiliated withDivision of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine
  • , Dennis McCartyAffiliated withDepartment of Public Health and Preventive Medicine, Oregon Health & Science University
  • , Richard D. MooreAffiliated withDivision of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine
  • , Jonathan A. CohnAffiliated withDivision of Infectious Diseases, Department of Medicine, Wayne State University School of Medicine
  • , Victoria L. SharpAffiliated withCenter for Comprehensive Care, St. Luke’s-Roosevelt Hospital Center
  • , Mary Catherine BeachAffiliated withDivision of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine

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Abstract

The objective of this study was to estimate the influence of substance use on the quality of patient-provider communication during HIV clinic encounters. Patients were surveyed about unhealthy alcohol and illicit drug use and rated provider communication quality. Audio-recorded encounters were coded for specific communication behaviors. Patients with vs. without unhealthy alcohol use rated the quality of their provider’s communication lower; illicit drug user ratings were comparable to non-users. Visit length was shorter, with fewer activating/engaging and psychosocial counseling statements for those with vs. without unhealthy alcohol use. Providers and patients exhibited favorable communication behaviors in encounters with illicit drug users vs. non-users, demonstrating greater evidence of patient-provider engagement. The quality of patient-provider communication was worse for HIV-infected patients with unhealthy alcohol use but similar or better for illicit drug users compared with non-users. Interventions should be developed that encourage providers to actively engage patients with unhealthy alcohol use.

Keywords

Alcoholism Substance-related disorders Communication HIV Quality of health care Patient satisfaction