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Communication prior to antiretroviral initiation
Wynne Callon1, Somnath Saha2, Ira B Wilson3
1Dartmouth Hitchcock Medical Center.
Communication & Medicine
|February 7, 2025
Summary
High-quality clinician-patient communication is vital for starting antiretroviral therapy (ART) in HIV care. However, discussions often miss key topics like adherence barriers and patient understanding, highlighting a need for improved communication strategies.
Area of Science:
- Medical communication
- Public Health
- Infectious Diseases
Background:
- Clinician-patient communication is crucial for initiating antiretroviral therapy (ART) in HIV care.
- Guidelines for ART initiation discussions exist but their implementation is unstudied.
Purpose of the Study:
- To analyze patient-clinician dialogues on ART initiation.
- To assess the frequency of guideline-recommended topics discussed.
- To describe communication patterns regarding ART initiation.
Main Methods:
- Content analysis of 24 audio-recorded patient-clinician dialogues.
- Comparison of dialogue content with established ART initiation guidelines.
Main Results:
- Patient readiness for ART was discussed in most visits (n=18).
- Other critical topics, including adherence, patient understanding, and social support, were discussed less frequently.
- Communication varied in addressing recommended topics.
Conclusions:
- Current ART initiation discussions may not fully cover all recommended topics.
- Implementation of systems like checklists and the teach-back method could improve communication and patient understanding.
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