Enhancing Patient Adherence: Promoting Engagement via Positive Patient-Provider Relationships in HIV/AIDS Care.

The face of HIV/AIDS has shifted. Traditionally disenfranchised groups including African Americans and those known to be current or past substance-users are disproportionately infected and affected by the domestic HIV/AIDS epidemic. While caring for all people living with HIV/AIDS (PLWHA) is a public health priority, there are vast disparities in HIV/AIDS care and outcomes linked to treatment engagement and medication adherence. Historically, providers and researchers have focused heavily on seeking effective interventions to promote medication adherence among patients engaged in care. After having modest success when concentrating solely on outcomes pertaining to medication adherence (i.e., medication taking), the definition of adherence is broadening. Adherence to medications is now thought to occur along a continuum of engagement in care with regard to chronic illnesses such as HIV/AIDS. Patient-provider communication styles that are consistent with a motivational interviewing (MI) style are useful in enhancing active engagement in care, with potential to promote better medication adherence. Positive patient-provider relationships may be conduits for positive changes in vulnerable patients' lives. Positive changes in individual patients' lives culminate to reduce disparities in health status between PLWHA on a population level.