AEGiS-15IAC: Physician-patient communication: A key factor in adherence to antiretroviral treatment. Results from a qualitative study with people living with HIV/AIDS in Mexico.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Physician-patient communication: A key factor in adherence to antiretroviral treatment. Results from a qualitative study with people living with HIV/AIDS in Mexico.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. MoOrD1086)

Herrera C, Caballero M, Campero L, Kendall T
National Institute of Public Health, Cuernavaca, Mexico

BACKGROUND: In Mexico, People Living with HIV/AIDS (PLWHA) confront stigma and discrimination in various spheres, including in the health sector, and access to antiretroviral therapy (ART) and medical care is uneven. PLWHA without guaranteed access to ART face the high costs of medication and laboratory tests. There have been few studies of Mexican PLWHA who have access to ART because it is assumed that their basic needs are being met. This study sought to describe social and medical support available to Mexican PLWHA from the perspective of infected and affected individuals.

METHODS: A qualitative sociological study that consisted of 68 in-depth interviews with: heterosexual, ambulatory male and female PLWHA who had known their diagnosis for at least 1 year; key individuals from their social network (family and friends); and leaders of support groups. Informants were selected from social security support groups (individuals with guaranteed free access to ART), hospitals for the general population (individuals without guaranteed access to ART), and non-governmental organizations (individuals with and without access to ART). Analysis was carried out using grounded theory.

RESULTS: Analysis reveals that despite having access to ART and medical care, Mexican PLWHA rarely adhere correctly to ART. Some of the associated factors are: lack of training among the majority of medical personnel, instances of discrimination, difficulties establishing good physician-patient communication and a consequent lack of patient confidence to speak openly about their behavior, and PWLHA decision-making about adherence based on previous experiences of sickness and health.

CONCLUSIONS: This study has permitted us to explore the complexity of some of the principal barriers to good physician-patient communication in Mexico. Overcoming such barriers is essential to ensure optimal treatment outcomes and improve the health and quality of life of Mexican PWLHA.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Communication, Physicians, Antiretroviral Therapy, Highly Active, Health Services Accessibility, Social Support, Health Personnel, Health Services Needs and Demand, Interviews, Family, Mexico, Female, Male, Humans, therapy, drug therapy

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MoOrD1086