Clinician gender is more important than gender concordance in quality of HIV care.
BACKGROUND
Previous studies have examined the impact of physician gender and gender concordance on preventive care, satisfaction, and communication. Less is known about how physician gender and gender concordance affect care for chronic illnesses, including HIV.


OBJECTIVE
This study sought to determine whether patient-clinician gender concordance (patient and clinician are of the same gender) influences receipt of protease inhibitor (PI) therapy and ratings of care among HIV-infected patients.


METHODS
We reviewed data from 1860 patients and 397 clinicians in the HIV Cost and Services Utilization Study, a nationally representative the association between gender concordance and time to first PI use, and multivariable logistic regression was utilized to examine the association of gender concordance with patients' problems with care and their overall rating of care.


RESULTS
Patients who had a male clinician received PIs earlier than those who had a female clinician (adjusted time ratio = 0.69 for having a male vs having a female clinician; P <or= 0.01). Gender concordance was not a significant predictor of time to PI use. Gender discordance was associated with problems with feeling respected by clinicians. Female patients with a male clinician were most likely, and female patients with female clinicians were least likely, to report a problem with being treated with respect (P <or= 0.01 for the interaction term). Gender discordance was not associated with other problems with care or with overall ratings of care.


CONCLUSIONS
Gender discordance was associated with perceived problems of being treated with respect by clinicians, but not with time to receipt of PIs, overall ratings of care, coordination of care, or obtaining information. The perception of not being respected may represent a significant barrier to care that is particularly worse for women, in that most HIV-infected women receive their care from male clinicians.
Beran
Mary Sue
MS
Robert Wood Johnson Clinical Scholars Program, University of California, Los Angeles, Los Angeles, California, USA. beranm@parknicollet.com
Cunningham
William
W
Landon
Bruce E
BE
Wilson
Ira B
IB
Wong
Mitchell D
MD
D000328:Adult; D004363:Drug Utilization; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000628:therapy*; D017320:HIV Protease Inhibitors; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care; D012727:Sex Characteristics; D014481:United States; D016387:Women's Health
D017320:HIV Protease Inhibitors