Patient Health Literacy and Communication with Providers Among Women Living with HIV: A Mixed Methods Study

• Type of Material: Article
• Authors: Henna Budhwani, University of Alabama at Birmingham (UAB); C Ann Gakumo, University of Massachusetts Boston (UMB); Ibrahim Yigit, Ted University; Whitney Rice, Emory University; Faith E Fletcher, Baylor College of Medicine; Samantha Whitfield, University of Alabama at Birmingham (UAB); Sherica Ross, University of Alabama at Birmingham (UAB); Deborah J Konkle-Parker, University of Mississippi Medical Center (UMMC); Mardge H Cohen, Stroger Hospital of Cook County, Chicago; Gina Wingood, Emory University; Lisa R Metsch, Columbia University; Adaora A Adimora, University of North Carolina; Tonya N Taylor, State University of New York, Downstate Health Sciences University, Brooklyn; Tracey E Wilson, State University of New York, Downstate Health Sciences University, Brooklyn; Sheri D Weiser, University of California San Francisco; Oluwakemi Sosanya, Montefiore Medical Center, New York; Lakshmi Goparaju, Georgetown University; Stephan Gange, Johns Hopkins University; Mirjam-Colette Kempf, University of Alabama at Birmingham (UAB); Bulent Turan, Koc University; Janet M Turan, University of Alabama at Birmingham (UAB)
• Language: English
• Date: 2021-10-12
• Publisher: SPRINGER/PLENUM PUBLISHERS
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2021, The Author(s), under exclusive licence to Springer Science Business Media, LLC, part of Springer Nature
• Final Published Version (URL): http://dx.doi.org/10.1007/s10461-021-03496-2
• Title of Journal or Parent Work: AIDS AND BEHAVIOR
• Volume: 26
• Issue: 5
• Start Page: 1422
• End Page: 1430
• Keywords: Social Sciences, Biomedical; CARE SETTINGS; Health literacy; HIV; African American; MEDIATING ROLES; Health communication; Biomedical Social Sciences; STIGMA; Science & Technology; PEOPLE; RACISM; ADHERENCE; Latina; Public, Environmental & Occupational Health; Social Sciences; Life Sciences & Biomedicine; QUALITY; OUTCOMES; IMPACT; DETERMINANTS

Abstract

In this mixed-methods study, we examine the relationship between provider communication and patient health literacy on HIV continuum of care outcomes among women living with HIV in the United States. We thematically coded qualitative data from focus groups and interviews (N = 92) and conducted mediation analyses with quantitative survey data (N = 1455) collected from Women’s Interagency HIV Study participants. Four qualitative themes related to provider communication emerged: importance of respect and non-verbal cues; providers’ expressions of condescension and judgement; patient health literacy; and unclear, insufficient provider communication resulting in diminished trust. Quantitative mediation analyses suggest that higher health literacy is associated with higher perceived patient–provider interaction quality, which in turn is associated with higher levels of trust in HIV providers, improved antiretroviral medication adherence, and reduced missed clinical visits. Findings indicate that enhancing provider communication and bolstering patient health literacy could have a positive impact on the HIV continuum of care.