Race, Relationships, and Trust in Providers among Black Patients with HIV/AIDS

Earl, Tara R.; Saha, Somnath; Lombe, Margaret; Korthuis, P. Todd; Sharp, Victoria L.; Cohn, Johnathan; Moore, Richard D.; Beach, Mary Catherine

doi:10.1093/swr/svt017

Cited by 45 publications

(31 citation statements)

References 31 publications

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“…Experienced providers are more accepting of individuals with various medical issues and additional clinical experiences allow them to deliver standardized care, regardless of the client’s background. This is consistent with the finding that being older is related to higher levels of provider–client interaction, which can be explained by older providers having greater provider–client trust, being considered to be more experienced, and being more aware of the clients’ needs (Earl et al, 2013). Experience working with drug users might help providers to develop knowledge and skills that make it easier to treat such clients more effectively.…”

Section: Discussionsupporting

confidence: 88%

Report on Provider–Client Interaction From 68 Methadone Maintenance Clinics in China

Comulada

Lin

et al. 2016

Health Communication

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Provider–client interaction is an integral of clinical practice and central to the delivery of high-quality medical care. This article examines factors related to the provider–client interaction in the context of methadone maintenance treatment (MMT). Data were collected from 68 MMT clinics in China. In total, 418 service providers participated in the survey. Linear mixed effects regression models were performed to identify factors associated with provider–client interaction. It was observed that negative attitude toward drug users was associated with lower level of provider–client interaction and less time spent with each client. Other factors associated with lower level of interaction included being female, being younger, being a nurse, and fewer years in medical field. Higher provider–client interaction was associated with provider reported job satisfaction. The findings of this study call for a need to address provider negative attitudes that can impact provider–client interaction and the effectiveness of MMT. Future intervention efforts targeting MMT providers should be tailored by gender, provider type, and medical experiences.

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Section: Discussionsupporting

confidence: 88%

Report on Provider–Client Interaction From 68 Methadone Maintenance Clinics in China

Comulada

Lin

et al. 2016

Health Communication

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“…Clinics with discourteous staff and complicated appointment scheduling and referral processes may deter patients from returning [21]. While, providers who gain patients' trust, are responsive, display empathy, and provide individualized care can encourage both retention and adherence among patients [21, 41, 42]. In an analysis of patient perceptions of provider attitudes, those with a gap in care of more than one year were more likely to perceive that the provider didn't listen carefully to them or disliked caring for HIV-infected people [43].…”

Section: Barriers and Facilitators To Retention And Adherencementioning

confidence: 99%

Retention in Care and Medication Adherence: Current Challenges to Antiretroviral Therapy Success

Holtzman

Brady

Yehia

2015

Drugs

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Health behaviors, such as retention in HIV medical care and adherence to antiretroviral therapy (ART), pose major challenges to reducing new HIV infections, addressing health disparities, and improving health outcomes. Andersen's Behavioral Model of Health Service Use provides a conceptual framework for understanding how patient and environmental factors affect health behaviors and outcomes, which can inform the design of intervention strategies. Factors affecting retention and adherence among persons with HIV include patient predisposing factors (e.g. mental illness, substance abuse), patient enabling factors (e.g. social support, reminder strategies, medication characteristics, transportation, housing, insurance), and health care environment factors (e.g. pharmacy services, clinic experiences, provider characteristics). Evidence-based recommendations for improving retention and adherence include 1) systematic monitoring of clinic attendance and ART adherence; 2) use of peer or paraprofessional navigators to re-engage patients in care and help them remain in care; 3) optimization of ART regimens and pharmaceutical supply chain management systems 4) provision of reminder devices and tools; 5) general education and counseling; 6) engagement of peer, family, and community support groups; 7) case management; and 8) targeting patients with substance abuse and mental illness. Further research is needed on effective monitoring strategies and interventions that focus on improving retention and adherence, with specific attention to the health care environment.

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“…Saha [34] reported that greater "cultural distance" between providers of HIV care and patients living with HIV was associated with disparities that appeared not to be based on race or ethnicity. However, non-White patients had lower levels of trust, adherence to antiretroviral therapies, and lower rates of viral suppression [57]. Additional research should examine neighborhood and community-level factors that may contribute to HIV and other disparities.…”

Section: Discussionmentioning

confidence: 99%

Racial Health Disparities in a Cohort of 5,135 Transgender Veterans

Brown

Jones

2014

J. Racial and Ethnic Health Disparities

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Objective There are no large-scale studies of racial health disparities in transgender patients. The Veterans Health Administration (VHA) is the largest health-care system in the United States and was an early adopter of electronic health records. We present new data on medical and mental health disparities in a large population of transgender veterans. Method Using four ICD-9-CM codes, we identified a cohort of transgender veterans who presented for VHA care from1996-2013. A total of 5,135 transgender veterans were identified, 387 were non-Hispanic Black and 4,120 were nonHispanic White. These two groups were compared to determine if medical and/or mental health disparities existed. Results Black transgender veterans had increased odds to be diagnosed with alcohol abuse (adjusted odds ratio Conclusions This is the first study to examine a large cohort of transgender patients for the presence of racial disparities in psychiatric and medical health outcome disparities using retrospective medical chart data. Black transgender veterans were found to have a greater likelihood of social disadvantage and prevalence of several mental and medical conditions compared to White transgender veterans. Racial disparities occurred in a context of global health disparities in transgender veterans, as a group, compared to non-transgender veterans. These findings may have implications for policy, prevention strategies, and health-care delivery in VA and other health-care systems.

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Race, Relationships, and Trust in Providers among Black Patients with HIV/AIDS

Cited by 45 publications

References 31 publications

Report on Provider–Client Interaction From 68 Methadone Maintenance Clinics in China

Report on Provider–Client Interaction From 68 Methadone Maintenance Clinics in China

Retention in Care and Medication Adherence: Current Challenges to Antiretroviral Therapy Success

Racial Health Disparities in a Cohort of 5,135 Transgender Veterans

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