Adults living with HIV who have compassionate care providers start and stay in treatment longer

Rutgers study reveals that HIV-positive adults are more likely to pursue lifesaving treatments if their primary care providers show respect, unconditional empathy, and demonstrate their ability to badociate with patients to help them make decisions.

The systematic review appears in the Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports.

The results showed that the complexity of the disease, the treatment regimen, and the overall health system often overwhelms the patient and that the fear of stigma often prevents it from starting or continuing treatment. The researchers found that patients needed help to understand their illness and their needs for care. They used understandable language to translate complex information, told them what to expect, and reinforced the fact that HIV was now a treatable, yet complex, chronic disease.

"Today, HIV is considered a treatable chronic disease, however, this study found that many patients continue to view it as a death sentence," said lead author Andrea Norberg, director Executive of the François-Xavier Bagnoud Center of the Rutgers School of Nursing. which provides care for people living with HIV, infectious diseases and immunological disorders. "We know that people who know about HIV, who are taking care of and taking medicine for antiretroviral treatment, are still in good health, and our challenge is to reach people who are diagnosed with HIV and who are neither incarcerated nor followed up on an ongoing basis. United States, this represents about 49% of the 1.1 million people diagnosed. "

The researchers included 41 studies published between 1997 and 2017. The population samples included adults living with HIV and their health care providers. All HIV-positive adults were between the ages of 18 and 65 and represented different races and ethnicities, badual orientations and gender identities. Health care providers included physicians, nurse practitioners, medical badistants, pharmacists, social workers, and others. Included studies included 1,597 participants.

They found that many patients are victims of stigma and lack of compbadion often due to the ignorance of primary health care providers about HIV and the risks of transmission. The resultant poor communication between providers and patients means that many patients are unable to seek or remain in care and to not adhere to antiretroviral drugs.

Patients reported feeling "burned" by providers who often thought that they were not taking medication. Norberg suggested that providers would be better able to get information from patients by allowing them to be honest, by informing themselves of their health goals and by explaining to them how other patients managed the treatment. .

Conversely, the researchers found that patients were more likely to adhere to HIV treatment when their primary care providers displayed empathy, real listening, confidence, consideration of the whole person. and involvement in decision making. However, many patients stated that health care providers considered care only as "a prescription for antiretroviral drugs".

"Providers should use a common language, not medical jargon, to inform patients about HIV, drugs, and ways to lead healthy lives," Norberg said. "They should teach them the disease, the drugs, the side effects and the significance of the tests."

The researchers noted that providers who help patients navigate the health system, provide a one-stop service for services and provide connections to psychological support, health insurance, drugs, transportation and d & # 39; Other services can help their patients stay involved in care.

Primary health care providers can enroll in professional trainings to improve their knowledge of HIV, use their motivational interviewing skills, and seek opportunities for experiential learning, observation and observation. practical work in direct contact with HIV-positive patients, said Norberg.