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Original Research

If someone cares about you, you are more apt to come around: improving HIV care engagement by strengthening the patient–provider relationship

, , , , &
Pages 919-927 | Published online: 24 May 2018
 

Abstract

Purpose

The patient–provider relationship is a central factor that can promote or hinder long-term engagement in care among people living with chronic illnesses. In this paper, we explore characteristics of the patient–provider relationship that facilitated or hindered engagement in care among patients receiving care at HIV specialty clinics.

Patients and methods

We conducted 6 focus group discussions with a total of 43 well-retained and less well-retained HIV+ patients in San Francisco, Seattle, and Birmingham, to elicit a wide range of perspectives on engagement in HIV care. Borrowing from the field of psychotherapy, we examined patient–provider relationship characteristics through the lens of the therapeutic alliance, and with regard to their therapeutic efficacy and impact on patient engagement.

Results

The majority of participants emphasized how a strong patient–provider relationship defined by trust, intimacy, and collaboration promoted engagement, while a weak patient–provider relationship impeded engagement.

Conclusion

We discuss practical strategies and therapeutic techniques that may be helpful to providers in building strong patient–provider relationship and contend that a strong patient–provider relationship is crucial for patients to feel cared for during clinical encounters, which can promote long-term and sustained engagement in HIV care.

Disclosure

The authors report no conflicts of interest in this work.