AIDS and Behavior

, Volume 18, Issue 7, pp 1279–1287

Provider–Patient Communication About Adherence to Anti-retroviral Regimens Differs by Patient Race and Ethnicity

Authors

    • Department of Health Services, Policy and PracticeBrown University
  • Yoojin Lee
    • Department of Health Services, Policy and PracticeBrown University
  • William H. Rogers
    • Institute for Clinical Research and Health Policy StudiesTufts Medical Center
  • Mary Catherine Beach
    • Johns Hopkins University School of Medicine
  • Somnath Saha
    • Department of Medicine, Department of Public Health & Preventive MedicineOregon Health and Science University
  • P. Todd Korthuis
    • Department of Medicine, Department of Public Health & Preventive MedicineOregon Health and Science University
  • Victoria Sharp
    • St. Lukes-Roosevelt
  • Jonathan Cohn
    • Wayne State University
  • Richard Moore
    • Johns Hopkins University School of Medicine
  • Ira B. Wilson
    • Department of Health Services, Policy and PracticeBrown University
Original Paper

DOI: 10.1007/s10461-014-0697-z

Cite this article as:
Laws, M.B., Lee, Y., Rogers, W.H. et al. AIDS Behav (2014) 18: 1279. doi:10.1007/s10461-014-0697-z

Abstract

Disparities in HIV care and outcomes negatively affect Black and Hispanic patients. Features of clinical communication may be a factor. This study is based on coding transcripts of 404 routine outpatient visits by people with HIV at four sites, using a validated system. In models adjusting for site and patient characteristics, with provider as a random effect, providers were more “verbally dominant” with Black patients than with others. There was more discussion about ARV adherence with both Black and Hispanic patients, but no more discussion about strategies to improve adherence. Providers made more directive utterances discussing ARV treatment with Hispanic patients. Possible interpretations of these findings are that providers are less confident in Black and Hispanic patients to be adherent; that they place too much confidence in their White, non-Hispanic patients; or that patients differentially want such discussion. The lack of specific problem solving and high provider directiveness suggests areas for improvement.

Keywords

Health care disparitiesHIVPhysician–patient communicationMedication adherence

Copyright information

© Springer Science+Business Media New York 2014