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

Research output: Contribution to journalArticle

15 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1279-1287
Number of pages9
JournalAIDS and Behavior
Volume18
Issue number7
DOIs
StatePublished - Jul 2014

Keywords

  • HIV
  • Health care disparities
  • Medication adherence
  • Physician-patient communication

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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