HIV: Mutual respect between patient and doctor may boost ART adherence post-prison | Health Justice

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Takeaway

  • Patient perception that doctors are trusted and respected people in their lives served as a “social anchor” for patients newly released from prison or jail.
  • Patients who perceived mutual respect between doctor and patient reported higher levels of motivation to adhere to antiretroviral treatment (ART).

Methods

  • In-depth qualitative interviews with 30 people with HIV released from prison/jail in the last three months.
  • Participants were recruited from two large quantitative studies of linkage to care and health behavior.
  • Questions centered on participants’ barriers to and facilitators of ART adherence.
  • Patient report of ART adherence was not confirmed with medical records or quantitative data.
  • Inductive close reading and constant comparison were used to analyze data.

Key Results

  • Four themes emerged as pivotal areas that could enable or undermine ART adherence:
    • Social isolation in resource-poor communities.
    • Double jeopardy, in which, to alleviate isolation, participants reached out to “untrustworthy friends from their drug use networks,” which led to relapse and lack of adherence.
    • Search for belonging, including seeking meaning to their lives.
    • Trust and respect, including from and with healthcare providers.
    • To avoid double jeopardy, patients reported seeking new “social anchors,” including their physicians.
    • Physicians often represented trusted and respected people in their lives.
    • Trust in physicians and the perception that respect was mutual between patient and physician was reported to motivate ART adherence.

Why This Matters

  • ART adherence is essential to viral suppression, longevity and health for people with HIV.
  • ART adherence resulting in suppressed viral load can reduce HIV transmission by as much as 96 percent.