AIDS and Behavior

, Volume 18, Issue 7, pp 1279–1287 | Cite as

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

  • M. Barton Laws
  • Yoojin Lee
  • William H. Rogers
  • Mary Catherine Beach
  • Somnath Saha
  • P. Todd Korthuis
  • Victoria Sharp
  • Jonathan Cohn
  • Richard Moore
  • Ira B. Wilson
Original Paper

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 

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • M. Barton Laws
    • 1
  • Yoojin Lee
    • 1
  • William H. Rogers
    • 2
  • Mary Catherine Beach
    • 3
  • Somnath Saha
    • 4
  • P. Todd Korthuis
    • 4
  • Victoria Sharp
    • 5
  • Jonathan Cohn
    • 6
  • Richard Moore
    • 3
  • Ira B. Wilson
    • 1
  1. 1.Department of Health Services, Policy and PracticeBrown UniversityProvidenceUSA
  2. 2.Institute for Clinical Research and Health Policy StudiesTufts Medical CenterBostonUSA
  3. 3.Johns Hopkins University School of MedicineBaltimoreUSA
  4. 4.Department of Medicine, Department of Public Health & Preventive MedicineOregon Health and Science UniversityPortlandUSA
  5. 5.St. Lukes-RooseveltNew YorkUSA
  6. 6.Wayne State UniversityDetroitUSA

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