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 language | English (US) |
|---|---|
| Pages (from-to) | 1279-1287 |
| Number of pages | 9 |
| Journal | AIDS and Behavior |
| Volume | 18 |
| Issue number | 7 |
| DOIs | |
| State | Published - 2014 |
Fingerprint
Keywords
- Health care disparities
- HIV
- Medication adherence
- Physician-patient communication
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Infectious Diseases
- Social Psychology
- Medicine(all)
Cite this
Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity. / Laws, M. Barton; Lee, Yoojin; Rogers, William H.; Beach, Mary Catherine; Saha, Somnath (Som); Korthuis, Philip (Todd); Sharp, Victoria; Cohn, Jonathan; Moore, Richard; Wilson, Ira B.
In: AIDS and Behavior, Vol. 18, No. 7, 2014, p. 1279-1287.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity
AU - Laws, M. Barton
AU - Lee, Yoojin
AU - Rogers, William H.
AU - Beach, Mary Catherine
AU - Saha, Somnath (Som)
AU - Korthuis, Philip (Todd)
AU - Sharp, Victoria
AU - Cohn, Jonathan
AU - Moore, Richard
AU - Wilson, Ira B.
PY - 2014
Y1 - 2014
N2 - 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.
AB - 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.
KW - Health care disparities
KW - HIV
KW - Medication adherence
KW - Physician-patient communication
UR - http://www.scopus.com/inward/record.url?scp=84902298191&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84902298191&partnerID=8YFLogxK
U2 - 10.1007/s10461-014-0697-z
DO - 10.1007/s10461-014-0697-z
M3 - Article
C2 - 24464408
AN - SCOPUS:84902298191
VL - 18
SP - 1279
EP - 1287
JO - AIDS and Behavior
JF - AIDS and Behavior
SN - 1090-7165
IS - 7
ER -