title: Building Trust and Relationships Between Patients and Providers: An Essential Complement to Health Literacy in HIV Care.
abstract: Health literacy is important for access to and quality of HIV care. While most models of health literacy acknowledge the importance of the patient-provider relationship to disease management, a more nuanced understanding of this relationship is needed. Thematic analysis from 28 focus groups with HIV-experienced patients (n = 135) and providers (n = 71) identified a long-term and trusting relationship as an essential part of HIV treatment over the continuum of HIV care. We found that trust and relationship building over time were important for patients with HIV as well as for their providers. An expanded definition of health literacy that includes gaining a patient's trust and engaging in a process of health education and information sharing over time could improve HIV care. Expanding clinical perspectives to include trust and the importance of the patient-provider relationship to a shared understanding of health literacy may improve patient experiences and engagement in care.
authors.forename: Carol
authors.initials: C
authors.lastname: Dawson-Rose
authors.forename: Yvette P
authors.initials: YP
authors.lastname: Cuca
authors.forename: Allison R
authors.initials: AR
authors.lastname: Webel
authors.forename: Solymar S
authors.initials: SS
authors.lastname: Solís Báez
authors.forename: William L
authors.initials: WL
authors.lastname: Holzemer
authors.forename: Marta
authors.initials: M
authors.lastname: Rivero-Méndez
authors.forename: Lucille
authors.initials: L
authors.lastname: Sanzero Eller
authors.forename: Paula
authors.initials: P
authors.lastname: Reid
authors.forename: Mallory O
authors.initials: MO
authors.lastname: Johnson
authors.forename: Jeanne
authors.initials: J
authors.lastname: Kemppainen
authors.forename: Darcel
authors.initials: D
authors.lastname: Reyes
authors.forename: Kathleen
authors.initials: K
authors.lastname: Nokes
authors.forename: Patrice K
authors.initials: PK
authors.lastname: Nicholas
authors.forename: Ellah
authors.initials: E
authors.lastname: Matshediso
authors.forename: Keitshokile Dintle
authors.initials: KD
authors.lastname: Mogobe
authors.forename: Motshedisi B
authors.initials: MB
authors.lastname: Sabone
authors.forename: Esther I
authors.initials: EI
authors.lastname: Ntsayagae
authors.forename: Sheila
authors.initials: S
authors.lastname: Shaibu
authors.forename: Inge B
authors.initials: IB
authors.lastname: Corless
authors.forename: Dean
authors.initials: D
authors.lastname: Wantland
authors.forename: Teri
authors.initials: T
authors.lastname: Lindgren
mesh_terms: D000328:Adult; D003219:Confidentiality; D003299:Cooperative Behavior; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010817:Physician-Patient Relations; D011369:Professional-Patient Relations; D036301:Qualitative Research; D035502:Trust
keywords: HIV; HIV self-management; health literacy; patient–provider relationship