- 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).
- 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.
- 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.