Patient-Provider Communication and Information, Motivation, and Behavioral Skills in HIV-Positive Adults Initiating Antiretroviral Therapy in Haiti

J Int Assoc Provid AIDS Care. 2020 Jan-Dec:19:2325958220952631. doi: 10.1177/2325958220952631.

Abstract

While Haiti has scaled up use of antiretroviral therapy (ART), current studies suggest sub-optimal adherence threatens long-term viral suppression in this understudied setting. Patient-provider communication (PPC) and information, motivation, and behavioral skills (IMB) have been implicated in ART adherence globally. However, no studies have examined their relevance in Haiti. The present mixed-methods study utilized cross-sectional survey data from 128 ART-initiating patients at 2 large HIV treatment sites in Haiti, as well as observational data from 12 clinic visits, to document associations between adherence-related PPC and IMB. Multivariate regression analyses suggested that PPC is associated with IMB constructs. At the bivariate level, more effective PPC was associated with higher levels of adherence-related information and motivation, but not behavioral skills. Observational findings indicate infrequent and non-collaborative adherence support. Taken together, findings lay the groundwork for additional research in the area of PPC, IMB, and ART adherence in Haiti.

Keywords: ART adherence; HIV/AIDS; Haiti; antiretroviral therapy; information motivation behavior skills theory; patient-provider communication.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active*
  • Communication*
  • Cross-Sectional Studies
  • HIV Infections / drug therapy*
  • HIV Infections / ethnology
  • HIV Infections / psychology*
  • Haiti / epidemiology
  • Humans
  • Medication Adherence / psychology*
  • Middle Aged
  • Models, Psychological
  • Motivation*
  • Professional-Patient Relations

Substances

  • Anti-HIV Agents