Enhancing Patient-Provider Interactions

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.
  • Meyers K, Price D, Golub S. Behavioral and social science research to support accelerated and equitable implementation of long-acting preexposure prophylaxis. Curr Opin HIV AIDS. 2020 Jan;15(1):66-72.
    
    
• 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.
  • Boissy A, Windover AK, Bokar D, Karafa M, Neuendorf K, Frankel RM, Merlino J, Rothberg MB. Communication Skills Training for Physicians Improves Patient Satisfaction. J Gen Intern Med. 2016 Jul;31(7):755-61.
    
    

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.
  • Rogers BG, Whiteley L, Haubrick KK, Mena LA, Brown LK. Intervention Messaging About Pre-Exposure Prophylaxis Use Among Young, Black Sexual Minority Men. AIDS Patient Care STDS. 2019 Nov;33(11):473-481.
    
    
• 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.
  • Golub SA. PrEP Stigma: Implicit and Explicit Drivers of Disparity. Curr HIV/AIDS Rep. 2018 Apr;15(2):190-197.
    
    
• 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.
  • Jackson GY, Darlington CK, Van Tieu H, Brawner BM, Flores DD, Bannon JA, Davis A, Frye V, Chittamuru D, Gugerty P, Koblin BA, Teitelman AM. Women's views on communication with health care providers about pre-exposure prophylaxis (PrEP) for HIV prevention. Cult Health Sex. 2021 Feb 4:1-16.22
    
    

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.
  • Braksmajer A, Fedor TM, Chen SR, Corales R, Holt S, Valenti W, McMahon JM. Willingness to Take PrEP for HIV Prevention: The Combined Effects of Race/Ethnicity and Provider Trust. AIDS Educ Prev. 2018 Feb;30(1):1-12.
    
    

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.
  • Meyers K, Price D, Golub S. Behavioral and social science research to support accelerated and equitable implementation of long-acting preexposure prophylaxis. Curr Opin HIV AIDS. 2020 Jan;15(1):66-72.
    
    
• 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. .
  • Stacey D, Légaré F, Lewis K, Barry MJ, Bennett CL, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R, Trevena L. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2017 Apr 12;4(4):CD001431.