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Higher Quality Communication and Relationships Are Associated With Improved Patient Engagement in HIV Care

Flickinger, Tabor E. MD, MPH*; Saha, Somnath MD, MPH; Moore, Richard D. MD, MHS*; Beach, Mary C. MD, MPH*

JAIDS Journal of Acquired Immune Deficiency Syndromes: July 1st, 2013 - Volume 63 - Issue 3 - p 362–366
doi: 10.1097/QAI.0b013e318295b86a
Brief Report: Clinical Science

Abstract: Patient retention in HIV care may be influenced by patient–provider interactions. In an urban, academic HIV clinic, 1363 patients rated the quality of communication and relationships with their providers on 5 domains. We used linear regressions to investigate associations between these 5 domains and appointment adherence. In multivariate analysis, patients kept more appointments if providers treated them with dignity and respect, listened carefully to them, explained in ways they could understand, and knew them as persons. Being involved in decisions was not significantly associated with appointment adherence. Enhancing providers' skills in effective communication and relationship building may improve patient retention in HIV care.

*Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; and

Department of Medicine, Oregon Health and Science University, Portland, OR.

Correspondence to: Tabor E. Flickinger, MD, MPH, Johns Hopkins University School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD 21287 (e-mail:

T.E.F. was supported by the National Institutes of Health (5 T32 HL007180-35); S.S. was supported by the Department of Veterans Affairs; M.C.B. was supported by the Agency for Healthcare Research and Quality (K08 HS013903-05); and both M.C.B. and S.S. were supported by Robert Wood Johnson Generalist Physician Faculty Scholars Awards.

None of the funders had a role in the design and conduct of this analysis, nor was it subject to their final approval. None of the authors have any relevant financial conflicts of interest.

Received November 29, 2012

Accepted March 26, 2013

© 2013 Lippincott Williams & Wilkins, Inc.