FEATURE

Strengthen Connections With
HIV-positive Patients

PATIENT CARE

Recognize the Patient Mindset

Before starting HIV-positive patients on treatment, a readiness assessment is warranted to evaluate their knowledge about HIV treatment (including the importance of adherence and consequences of non-adherence) and also to assess their motivation to succeed on treatment, which includes identifying potential adherence barriers.1

Am I going to lose...

my health?

my job?

my friends?

my partner?

When patients are overwhelmed by negative emotions, they may find it difficult to keep up with medical issues and appointments.2 Taking the following steps may help address patients' mental and emotional health1, 2:

1. Assess patients' cognitive function and emotional state, including whether they have an emotional support system or need counseling to help them come to terms with their diagnosis. Screen for mental illnesses and substance use.

2. Provide or make appropriate referrals to crisis counseling, support groups, and mental health or substance abuse treatment.

3. Connect patients to case managers or patient educators who can help patients learn to adapt to healthcare systems and lifestyle changes.

4. Educate patients to confront stigma. When patients understand clearly how HIV is transmitted, for example, they may be better prepared to fight the stigma surrounding HIV and the fear of contagion.

5. Help patients with disclosure. HIV-positive patients may benefit from support groups or therapy sessions around disclosure. Clinic staff might also invite partners for disclosure in-clinic or refer patients to local health department to assist with anonymous partner notification.

Next: Bridge Mistrust >

References: 1. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. AIDSinfo website. https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/30/adherence-to-art. Published July 14, 2016. Accessed March 16, 2017.
2. Guide for HIV/AIDS Clinical Care. https://aidsetc.org/guide/contents. Published April 2014. Accessed March 16, 2017.

PATIENT CARE

Improve Communication

HIV-positive patients need to be informed about treatment goals, medication regimens, the importance of adherence, and the consequence of nonadherence.1 Below are a few best practices in communicating with HIV-positive patients to help keep the lines of communication open and to educate patients with a solid understanding of what to expect and how to succeed in HIV care.

1. Set the stage for open dialogue. Share expectations early on with patients regarding communication: ask patients to be actively engaged in care, welcome questions and feedback, and invite openness about treatment and side effects.2

2. Speak in language patients easily understand. You may have to adjust the message to fit patients' literacy level, and information should be given in the patient's primary language. Use professional interpreters, case managers, and culturally diverse peer educators to bridge language and social barriers.2

3. Give information in simple terms. Patients' attention span and ability to absorb information may decline after the first 15-20 minutes of medical visits. Provide information in small amounts to help facilitate patient understanding.2

4. Repeat information in subsequent visits. Expect a learning curve with HIV patient education and repeat messages often to help patients digest important details about HIV care.2

5. Extend communication access. Welcome questions between visits by setting up a patient portal that allows patients to send private messages securely to clinic staff.2

Next: Enable Connection >

References: 1. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/30/adherence-to-art. Published July 14, 2016. Accessed March 16, 2017.
2. Guide for HIV/AIDS Clinical Care. https://aidsetc.org/guide/contents. Published April 2014. Accessed March 16, 2017.