title: Patient and provider priorities for self-reported domains of HIV clinical care.
abstract: We sought to understand how HIV-infected patients, their providers, and HIV care researchers prioritize self-reported domains of clinical care. Participants rank-ordered two lists of domains. A modified Delphi process was used for providers and researchers. Approximately 25% of patients were interviewed to discuss rationale for rank order choices. List 1 included anger, anxiety, depression, fatigue, physical function, pain, and sleep disturbance. List 2 included alcohol abuse, cognitive function, HIV stigma, HIV and treatment symptoms, medication adherence, positive affect, sexual risk behavior, sexual function, social roles, spirituality/meaning of life, and substance abuse. Seventy-four providers, 80 HIV care researchers, and 66 patients participated. Patients ranked context-based domains, such as HIV stigma, more highly than providers, while health behaviors, such as drug or alcohol use, ranked lower. Patients described a need to address wider-context challenges such as HIV stigma in order to positively impact health behaviors. Divergent patient and provider priorities highlight the importance of incorporating views from all stakeholders and suggests the need for a care approach that more effectively addresses contextual barriers to adverse health behaviors.
authors: a Center for AIDS Research , University of Washington , Seattle , WA 98104 , USA.
authors: Rob J
authors: RJ
authors: Fredericksen
authors: b Seattle Quality of Life Group , University of Washington , Seattle , WA 98104 , USA.
authors: Todd C
authors: TC
authors: Edwards
authors: c School of Medicine, Division of Infectious Diseases , University of Alabama at Birmingham , Birmingham , AL 35294 , USA.
authors: Jessica S
authors: JS
authors: Merlin
authors: d Department of General Internal Medicine , University of Washington , Seattle , WA 98104 , USA.
authors: Laura E
authors: LE
authors: Gibbons
authors: e Department of Global Health , University of Washington , Seattle , WA 98104 , USA.
authors: Deepa
authors: D
authors: Rao
authors: f Department of Medicine, Division of Infectious Diseases, Research and Informatics Service Center , University of Alabama at Birmingham , Birmingham , AL 35294 , USA.
authors: D Scott
authors: DS
authors: Batey
authors: g The Fenway Institute , Boston , MA 02215 , USA.
authors: Lydia
authors: L
authors: Dant
authors: h UCSD Medical Center - Owen Clinic , San Diego , CA 92103-8681 , USA.
authors: Edgar
authors: E
authors: Páez
authors: a Center for AIDS Research , University of Washington , Seattle , WA 98104 , USA.
authors: Anna
authors: A
authors: Church
authors: i Internal Medicine , University of Washington , Seattle , WA 98104 , USA.
authors: Paul K
authors: PK
authors: Crane
authors: j Department of Medicine , University of Washington , Seattle , WA 98104 , USA.
authors: Heidi M
authors: HM
authors: Crane
authors: b Seattle Quality of Life Group , University of Washington , Seattle , WA 98104 , USA.
authors: Donald L
authors: DL
authors: Patrick
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D015658:HIV Infections / Q000523:psychology / Q000628:therapy*; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D000071066:Patient Reported Outcome Measures; D012309:Risk-Taking; D057566:Self Report; D057545:Social Stigma; D014481:United States
keywords: HIV care; HIV-infected patients; patient-based measures; patient-reported outcomes; patient–provider communication