Dissatisfaction with medical care among women with HIV: Dimensions and associated factors

Abstract

Studies have shown that women with HIV/AIDS in the USA are less likely than men to have access to appropriate health care and to utilize services, including the latest antiretroviral drug therapies. One explanation for this underutilization is patient dissatisfaction with medical care. Dissatisfaction with care has been shown to be associated not only with treatment underutilization, but also with discontinuity of care and poor clinical outcomes. Using Patient Satisfaction Questionnaire data from a national cohort of women with HIV, this study examines levels of dissatisfaction across seven established dimensions of care, and uses multivariate analysis to identify patient characteristics associated with these dimensions (N = 1,303). Women were most dissatisfied with access to care and the technical quality of care, and least dissatisfied with financial aspects of care and their providers' interpersonal manner. Women who reported poor health, who had depressive symptomatology, who were not receiving antiretroviral therapy (ART), who had no consistent care providers or who were Hispanic/Latina were more likely to be dissatisfied across most dimensions of care. Implications for enhancing clinical care for women with HIV/AIDS and overcoming barriers to utilization of care and treatment are discussed.

Barriers to health-care and psychological distress among mothers living with HIV in Quebec (Canada)

“…As suggested by previous findings (Burke et al, 2003;Burke-Miller et al, 2006), the better the quality of communication with health-care providers, the less likely the participants were to report clinical psychological distress. While clinically distressed participants may be more likely to describe their medical resources in a negative way, it is also possible that the quality of communication with health-care providers, established in patient-centered behaviors, empathy, warmth, and interest, plays a role in helping MLHIV to better cope with adverse life events and in preventing psychological distress.…”

“…Overall, several studies suggest that the health care received by WLHIV are inadequate in regard to their needs, especially those who have dependent child or who want to become pregnant (Burke et al, 2003;Carter et al, 2013Carter et al, , 2014Hackl, Somlai, Kelly, & Kalichman, 1997;Kaida et al, 2013;Sohler et al, 2009;Stein et al, 2000). Data on the access to care and mental health that mothers living with HIV (MLVIH) have are scarce and dated.…”

“…Dissatisfaction with medical care and the physician-patient relationship, including patientdoctor communication and doctors' interpersonal manner, is associated with depressive symptomatology (Burke et al, 2003) and impedes medication adherence (Roberts, 2002). In contrast, a better quality of the physician-patient relationship is associated with higher HIV medication adherence (Roberts, 2002;Schneider, Kaplan, Greenfield, Li, & Wilson, 2004).…”

Geopolitical and Cultural Factors Affecting ARV Adherence on the US-Mexico Border

“…There are few descriptive studies available on Hispanic communities and the factors affecting HIV/AIDS treatment and adherence [5-13]. Little research on Hispanics addresses health access, treatment follow-up and the management of chronic conditions in U.S.-Mexico border areas.…”

Social Position as a Structural Determinant of Adherence to Treatment in Women Living with HIV/AIDS

“…Much of the research on HIV/AIDS adherence has been rooted in biomedical and behavioral approaches. Studied variables include age, gender, education (Carballo et al, 2004;Glass et al, 2006;Godin et al, 2005;Gordillo et al,1999;Ickovics & Meade, 2002;Mocroft et al, 2001;Spire et al, 2002;Sternhell & Corr, 2002), health beliefs, coping styles, self-efficacy, control perception, stress, anxiety, depression (Chesney, 2000;Ingersoll, 2004;Turner-Cobb et al, 2002), pharmacological regimen, side effects, relationship with health care providers, geographical barriers, and social support (Burke et al, 2003;Chesney, Morin & Sherr, 2000). Despite wide research on this topic, studies have not reach conceptual explanations about the relation between adherence to treatment in people diagnosed with HIV and structural determinants such as social position.…”