To tell or not to tell: Why people with HIV share or don't share with their physicians whether they are taking their medications as prescribed

• Published in: AIDS care Vol. 18; no. 5; pp. 520 - 528
• Main Authors: Kremer, H., Ironson, G.
• Format: Journal Article
• Language: English
• Published: Abingdon Taylor & Francis Group 01-07-2006; Taylor & Francis; Taylor & Francis Ltd
• Subjects: AIDS; Anti-HIV Agents - therapeutic use; Anti-Retroviral Agents - therapeutic use; Antiretroviral drugs; Antiretroviral therapy; Biological and medical sciences; Content analysis; Decision Making; Doctor-patient relationship; Doctor-Patient relationships; Female; Florida; Health care; HIV; HIV Infections - drug therapy; HIV Infections - psychology; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Interpersonal communication; Longitudinal Studies; Male; Medical care; Medical sciences; Medical treatment; Motivation; Noncompliance; Patient Compliance; Physician patient relationships; Physician-Patient Relations; Prescription drugs; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Qualitative research; Selfreport; Sexual Behavior; Sexual health; Sexually transmitted diseases; Surveys and Questionnaires; Therapeutical relation and framework; Treatments; Truth Disclosure; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; United States; North America; America; Florida; Social environment; Antiretroviral agent; Mental health; Drug compliance; Motivation; Medical prescription; Antiviral; Qualitative analysis; Public health; Content analysis; Communication; Human; Immunopathology; Health staff; Decision making; Retroviridae; AIDS; Immune deficiency; Lentivirus; Infection; Virus; Chemotherapy; Physician patient relation; Treatment; Viral disease; Human immunodeficiency virus
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540120600766020

This qualitative study examines whether HIV-positive people (N=79) tell their physicians whether they take antiretroviral treatment (ART) as prescribed and why. Interviews, analyzed with qualitative content-analysis, asked about taking/not taking ART and, if taking, whether they shared their reasons for non-adherence with their physician. Patients are more likely to inform physicians why they take than why they do not take ART (p<0.01). Only half of those not taking ART shared the reasons for their decision with their physician. The six motives were: anticipation that physicians will not support the decision, cannot discuss feelings, lack of trust in physician's opinion, unable to discuss spiritual/moral issues, no need for physician to know, and not seen physician yet. Of those taking ART, 21% did not tell their physician why they missed doses. The five motives were: not viewed as important, physician not asking, not seen physician yet, rarely non-adherent, no indications in surrogate markers. A significant proportion of patients are not taking their medications as prescribed and are not telling their physicians. To facilitate the chance that patients communicate with their physicians, physicians need to ask no need for and, while giving the patients medical information, create a non-judgmental, respectful atmosphere where patients feel comfortable sharing their personal view.