Substance Use and the Quality of Patient-Provider Communication in HIV Clinics

Division of General Internal Medicine and Geriatrics, Oregon Health & Science University, Portland, OR 97239-3098, USA.
AIDS and Behavior (Impact Factor: 3.49). 05/2011; 15(4):832-41. DOI: 10.1007/s10461-010-9779-8
Source: PubMed

ABSTRACT The objective of this study was to estimate the influence of substance use on the quality of patient-provider communication during HIV clinic encounters. Patients were surveyed about unhealthy alcohol and illicit drug use and rated provider communication quality. Audio-recorded encounters were coded for specific communication behaviors. Patients with vs. without unhealthy alcohol use rated the quality of their provider's communication lower; illicit drug user ratings were comparable to non-users. Visit length was shorter, with fewer activating/engaging and psychosocial counseling statements for those with vs. without unhealthy alcohol use. Providers and patients exhibited favorable communication behaviors in encounters with illicit drug users vs. non-users, demonstrating greater evidence of patient-provider engagement. The quality of patient-provider communication was worse for HIV-infected patients with unhealthy alcohol use but similar or better for illicit drug users compared with non-users. Interventions should be developed that encourage providers to actively engage patients with unhealthy alcohol use.

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