Patient and provider priorities for self-reported domains of HIV clinical care

• Published in: AIDS care 2015-10, Vol.27 (10), p.1255-1264
• Main Authors: Fredericksen, Rob J, Edwards, Todd C, Merlin, Jessica S., Gibbons, Laura E., Rao, Deepa, Batey, D. Scott, Dant, Lydia, Páez, Edgar, Church, Anna, Crane, Paul K., Crane, Heidi M., Patrick, Donald L.
• Format: Article
• Language: English
• Subjects: Adult; AIDS/HIV; Alcohol abuse; Alcohol use; Alcohols; Anxiety; Anxiety-Depression; Approximation; Attitude of Health Personnel; Attitudes; Cognitive ability; Cognitive functioning; Delphi method; Depression; Domains; Drug abuse; Drugs; Fatigue; Female; Health; Health Behavior; HIV; HIV care; HIV Infections - psychology; HIV Infections - therapy; HIV-infected patients; Human immunodeficiency virus; Humans; Interviews as Topic; Male; Meaning; Medical treatment; Medication Adherence; Mental depression; Middle Aged; Pain; Patient Acceptance of Health Care; Patient communication; Patient Reported Outcome Measures; patient-based measures; patient-provider communication; patient-reported outcomes; Patients; Physical ability; Positive emotions; Priorities; Risk behavior; Risk taking; Safe sexual practices; Self Report; Sexual behavior; Sexually transmitted diseases; Sleep; Sleep disorders; Social behavior; Social meaning; Social roles; Social Stigma; Spirituality; Stakeholders; STD; Stigma; Stigmas (botany); Substance abuse; United States
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2015.1050983

We sought to understand how HIV-infected patients, their providers, and HIV care researchers prioritize self-reported domains of clinical care. Participants rank-ordered two lists of domains. A modified Delphi process was used for providers and researchers. Approximately 25% of patients were interviewed to discuss rationale for rank order choices. List 1 included anger, anxiety, depression, fatigue, physical function, pain, and sleep disturbance. List 2 included alcohol abuse, cognitive function, HIV stigma, HIV and treatment symptoms, medication adherence, positive affect, sexual risk behavior, sexual function, social roles, spirituality/meaning of life, and substance abuse. Seventy-four providers, 80 HIV care researchers, and 66 patients participated. Patients ranked context-based domains, such as HIV stigma, more highly than providers, while health behaviors, such as drug or alcohol use, ranked lower. Patients described a need to address wider-context challenges such as HIV stigma in order to positively impact health behaviors. Divergent patient and provider priorities highlight the importance of incorporating views from all stakeholders and suggests the need for a care approach that more effectively addresses contextual barriers to adverse health behaviors.