ArticleSexually transmitted infections2017
'I am treated well if I adhere to my HIV medication': putting patient-provider interactions in context through insights from qualitative research in five sub-Saharan African countries.
Article in Sexually transmitted infections, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Being HIV positive and staying on antiretroviral therapy in Africa: A qualitative systematic review and theoretical model.PloS one · 2019Pooled it
- Can Traditional Health Practitioners Deliver HIV Counseling and Testing Services? A Pilot Study in Rural South Africa.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Perceptions of Patient-Clinician Communication Among Adults With and Without Serious Illness.JAMA network open · 2025Article
- Article
- Core components of male-specific person-centred HIV care: a qualitative analysis from client and healthcare worker perspectives in Malawi.BMJ public health · 2024Article
- The heterogeneity among people re-engaging in antiretroviral therapy highlights the need for a differentiated approach: results from a cross-sectional study in Johannesburg, South Africa.Journal of the International AIDS Society · 2024Article
- Article
- "Global mental health (Cambridge, England) · 2024Article
- Experiences and perceptions of urine sampling for tuberculosis testing among HIV patients: a multisite qualitative descriptive study.BMJ open · 2023Article
- Triple Benefit: Impact of an Integrated Early Childhood Development and PMTCT Intervention on ART Outcomes Among Mothers Living with HIV and Infants in Malawi-An Endline Evaluation.AIDS and behavior · 2023Observational
- Patterns of person-centred communications in public HIV clinics: a latent class analysis using the Roter interaction analysis system.Journal of the International AIDS Society · 2023Article
- Protocol for the pilot quasi-experimental controlled trial of a gender-responsive implementation strategy with providers to improve HIV outcomes in Uganda.Pilot and feasibility studies · 2022Article
- How HIV Clients Find Their Way Back to the ART Clinic: A Qualitative Study of Disengagement and Re-engagement with HIV Care in Malawi.AIDS and behavior · 2022Article
- Understanding the Risks and Benefits of a Patient Portal Configured for HIV Care: Patient and Healthcare Professional Perspectives.Journal of personalized medicine · 2022Article
- Article
- 'Staying alive' with antiretroviral therapy: a grounded theory study of people living with HIV in Peru.BMJ global health · 2021Article
- Throwing the bones to diagnose HIV: Views of rural South African traditional healers on undertaking HIV counselling and testing.AIDS care · 2021Article
- Integrated early childhood development services improve mothers' experiences with prevention of mother to child transmission (PMTCT) programs in Malawi: a qualitative study.BMC health services research · 2021Article
- 'You're only there on the phone'? A qualitative exploration of community, affect and agential capacity in HIV self-testing using a smartphone app.Sociology of health & illness · 2021Article
- Testing for saturation in qualitative evidence syntheses: An update of HIV adherence in Africa.PloS one · 2021Article
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9 authors.
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Abstract
objectivesThe nature of patient-provider interactions and communication is widely documented to significantly impact on patient experiences, treatment adherence and health outcomes. Yet little is known about the broader contextual factors and dynamics that shape patient-provider interactions in high HIV prevalence and limited-resource settings. Drawing on qualitative research from five sub-Saharan African countries, we seek to unpack local dynamics that serve to hinder or facilitate productive patient-provider interactions.
methodsThis qualitative study, conducted in Kisumu (Kenya), Kisesa (Tanzania), Manicaland (Zimbabwe), Karonga (Malawi) and uMkhanyakude (South Africa), draws upon 278 in-depth interviews with purposively sampled people living with HIV with different diagnosis and treatment histories, 29 family members of people who died due to HIV and 38 HIV healthcare workers. Data were collected using topic guides that explored patient testing and antiretroviral therapy treatment journeys. Thematic analysis was conducted, aided by NVivo V.8.0 software.
resultsOur analysis revealed an array of inter-related contextual factors and power dynamics shaping patient-provider interactions. These included (1) participants' perceptions of roles and identities of 'self' and 'other'; (2) conformity or resistance to the 'rules of HIV service engagement' and a 'patient-persona'; (3) the influence of significant others' views on service provision; and (4) resources in health services. We observed that these four factors/dynamics were located in the wider context of conceptualisations of power, autonomy and structure.
conclusionPatient-provider interaction is complex, multidimensional and deeply embedded in wider social dynamics. Multiple contextual domains shape patient-provider interactions in the context of HIV in sub-Saharan Africa. Interventions to improve patient experiences and treatment adherence through enhanced interactions need to go beyond the existing focus on patient-provider communication strategies.
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