Enhancing Patient-Provider Interactions
Throughout implementation of oral PrEP, research shows that provider training and engagement are crucial in facilitating HIV prevention. Learn more about how inclusive and stigma-reducing communication can be learned by providers, and can build trust and facilitate PrEP access.
WHAT WE KNOW
from the literature
1. Provider communication is a behavioral skill that can be learned.
- This paper synthesizes the evidence that provider communication skills (i.e., open-ended questions, active listening, accessible language, and demonstrating interest in the patient) are associated with patient satisfaction of care and improved health outcomes.
- This paper demonstrates that patient-proviver communication skills can be taught and can increase both patient satisfaction and the physician experience, including improved self-efficacy and reduced burnout.
2. Improving provider communication skills and use of inclusive language can reduce stigma.
- This paper points to the ways in which young, Black MSM feel targeted and marginalized by current PrEP messaging, suggesting that broad, inclusive language in PrEP messaging would be equally relevant to patients and be less stigmatizing.
- This paper summarizes aspects of PrEP care that can exacerbate and perpetuate PrEP stigma and highlights the ways in which language around PrEP candidacy (i.e., for patients “at very high risk” of HIV infection) can fuel stigma.
- This paper qualitatively explores how patient-provider communication impacts PrEP decision-making for women, finding that the decision to use PrEP is facilitated by trusting their provider, provider support, and receiving a specific and tailored recommendation for PrEP use by their provider.
3. Addressing provider bias (both current and historical) can build trust.
- This paper demonstrates how a patient’s race/ethnicity can impact their trust in their provider and, as a result, their willingness to consider PrEP use.
4. Tailored counseling, including a shared decision-making approach, can center patients’ needs to increase PrEP acceptability.
- This paper draws parallels between contraceptive counseling and HIV prevention counseling and summarizes research to support the development of tools that support patient-centered communication, address provider bias, and adopt a share-decision making approach to PrEP use.
- This review of decision aids in a variety of screening or treatment circumstances demonstrates that patients who use decision aids feel more knowledgeable and informed, are clearer about their values, play a more active role in decision-making and have more accurate risk perceptions. .
WHAT IT MEANS
for policies and programs
Patient-provider communication can harm or heal.
Provider communication skills can be learned and harnessed to improve patient satisfaction and health outcomes. Using inclusive language and discussions that demonstrate that a provider is listening and cares can build trust, reduce stigma, and increase patients’ receptivity to care.
Shared decision-making is key in an expanding PrEP landscape.
A shared decision-making approach in which the provider offers clinical expertise and the patient contributes expertise on their behavioral history and health-seeking goals offers a roadmap for helping patients navigate multiple HIV prevention modalities. Lessons from contraception and other fields in which health decisions are preference-sensitive should be harnessed to improve PrEP access.
BLUPrInt TOOLS
for this topic area
Resources and tools in these sections of the PrEP Program Builder are informed by and reflect the lessons in this key topic…