Physician communication behaviors from the perspective of adult HIV patients in Kenya.

Abstract

Objective We describe perceived physician communication behaviors and its association with adherence to care, among HIV patients in Kenya. Design This cross-sectional study was conducted between July and August 2011. Setting The study was conducted in three adult HIV clinics within the Academic Model Providing Healthcare program in western Kenya. Participants HIV adult patients. Main Outcome Measures Patient's predisposition to attend clinic, missed appointment and missed combined antiretroviral therapy (cART) medication. Results A total of 400 patients were enrolled and participated in the study; the median age was 38 years (IQR = 33–44) and 56.5% were female. Patients perceived physicians engaged in a high number of communication behaviors (mean = 3.80, range 1–5). A higher perceived general health status (P = 0.01), shorter distance to the health facility (P = 0.03) and lesser time spent at the health facility (P = 0.02) were associated with a higher number of perceived physician communication behaviors. Physician–patient relationship factors were not associated with physician communication behaviors. In addition, a higher number of perceived physician communication behaviors was associated with a very high likelihood of patients' attending the next HIV clinic [adjusted odds ratio (AOR): 1.89, 95% confidence interval (CI): 1.49–2.40], a lower likelihood of patients' missing an appointment (AOR: 0.75, 95% CI: 0.61–0.92) and missing cART medication (AOR: 0.68, 95% CI: 0.52–0.87). Conclusion Patients' perception of physician communication behaviors was found to be associated with their adherence to HIV care.