Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity

AIDS Behav. 2014 Jul;18(7):1279-87. doi: 10.1007/s10461-014-0697-z.


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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Black or African American*
  • Communication*
  • Cross-Sectional Studies
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / ethnology*
  • HIV Infections / psychology
  • Health Status Disparities*
  • Hispanic or Latino*
  • Humans
  • Male
  • Medication Adherence / ethnology
  • Medication Adherence / psychology
  • Medication Adherence / statistics & numerical data
  • Middle Aged
  • Needs Assessment
  • Physician-Patient Relations
  • White People*


  • Anti-HIV Agents