title: Influence of the First Consultation on Adherence to Antiretroviral Therapy for HIV-infected Patients.
abstract: BACKGROUND
  Physician attitude influences the way patients cope with diagnosis and therapy in chronic severe diseases such as cancer. Previous studies showed that such an effect exists in HIV care; it is likely that it begins with the first contact with a physician.
  
  
  OBJECTIVE
  We aimed to explore in HIV-infected persons their perception of the first consultation they had with an HIV specialist (PFC-H), and whether this perception correlates with adherence to antiretroviral therapy.
  
  
  METHODS
  The study was conducted in Grenoble University Hospital, France, a tertiary care center. Every antiretroviral-experienced patient was asked to freely complete a self-reported, anonymous questionnaire concerning retrospective PFC-H, present adherence (Morisky scale), and present perceptions and beliefs about medicine (BMQ scale).
  
  
  RESULTS
  One hundred and fifty-one questionnaires were available for evaluation. PFC-H score and adherence were correlated, independently from age, gender, and numbers of pill(s) and of pill intake(s) per day. BMQ score also correlated with adherence; structural equation analysis suggested that the effect of PFC-H on adherence is mediated by positive beliefs.
  
  
  CONCLUSIONS
  These results suggest that for HIV-infected persons, the perceptions remaining from the first consultation with an HIV specialist physician influence important issues such as adherence and perception about medicine. Physicians must be aware of this potentially long-lasting effect.
authors.affiliation: Service des Maladies Infectieuses, Centre Hospitalier Universitaire de Grenoble, Grenoble, France; Université Grenoble Alpes, Grenoble,France.
authors.forename: Marion
authors.initials: M
authors.lastname: Peyre
authors.affiliation: Université Grenoble Alpes, Grenoble,France; Laboratoire Inter-Universitaire de Psychologie - Personnalité, Cognition, Changement Social (LIP/PC2S) EA 4145, Université Grenoble Alpes, Grenoble, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Gauchet
authors.affiliation: Université Grenoble Alpes, Grenoble,France; Pharmacologie Clinique - CIC1406, Pôle Recherche, Centre Hospitalier Universitaire de Grenoble, Grenoble, France; Inserm, HP2, 38000 Grenoble, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Roustit
authors.affiliation: Service des Maladies Infectieuses, Centre Hospitalier Universitaire de Grenoble, Grenoble, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Leclercq
authors.affiliation: Service des Maladies Infectieuses, Centre Hospitalier Universitaire de Grenoble, Grenoble, France; Université Grenoble Alpes, Grenoble,France; Team "HIV and other human persistent viruses", Institut de Biologie Structurale, UMR 5075 UGA-CEA-CNRS, Grenoble, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Epaulard
keywords: Adherence; Antiretroviral; Beliefs about medicine; Consultation; Morisky; Patient perceptions