Is the Quality of the Patient-Provider Relationship Associated with Better Adherence and Health Outcomes for Patients with HIV?

Adherence to a highly active antiretroviral therapy (HAART) regimen is one of the most challenging issues facing patients with HIV and their providers. This study examines the association between patient-provider relationship quality and receipt of (HAART), adherence to HAART and health outcomes. Researchers conducted a cross-sectional analysis of 4,694 interviews with 1,743 patients before and after appointments with their primary care provider at an urban clinic specializing in HIV care. Results show an association between patients' perception of being “known as a person” and appropriate receipt of HAART as well as adherence to HAART. This association remains significant even after controlling for the length of time the patient was followed in the clinic, the patient's health beliefs and other patient features that the clinician might use to decide whether the patient was a candidate for HAART. In addition, the quality of the patient-provider relationship is associated with having an undetectable serum HIV-1 RNA, which is a strong clinical predictor of future health for patients with HIV. Efforts to improve health care quality, adherence and health of person with HIV should focus on improving the patient-provider relationship. Additional research is needed to determine exactly what patients were thinking when reporting that their provider knows or does not know them “as a person,” and how best to improve interpersonal aspects of care for patients with HIV and their providers.