Original Paper

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

  • M. Barton LawsAffiliated withDepartment of Health Services, Policy and Practice, Brown University Email author 
  • , Yoojin LeeAffiliated withDepartment of Health Services, Policy and Practice, Brown University
  • , William H. RogersAffiliated withInstitute for Clinical Research and Health Policy Studies, Tufts Medical Center
  • , Mary Catherine BeachAffiliated withJohns Hopkins University School of Medicine
  • , Somnath SahaAffiliated withDepartment of Medicine, Department of Public Health & Preventive Medicine, Oregon Health and Science University
  • , P. Todd KorthuisAffiliated withDepartment of Medicine, Department of Public Health & Preventive Medicine, Oregon Health and Science University
  • , Victoria SharpAffiliated withSt. Lukes-Roosevelt
  • , Jonathan CohnAffiliated withWayne State University
  • , Richard MooreAffiliated withJohns Hopkins University School of Medicine
    • , Ira B. WilsonAffiliated withDepartment of Health Services, Policy and Practice, Brown University

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

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 disparities HIV Physician–patient communication Medication adherence