Physician communication behaviors from the perspective of adult HIV patients in Kenya

Objective: We describe perceived physician communication behaviors and its association with adherence to care, among HIV patients in Kenya.

Design: This cross-sectional study was conducted between July and August 2011.

Setting: The study was conducted in three adult HIV clinics within the Academic Model Providing Healthcare program in western Kenya.

Participants: HIV adult patients.

Main outcome measures: Patient's predisposition to attend clinic, missed appointment and missed combined antiretroviral therapy (cART) medication.

Results: A total of 400 patients were enrolled and participated in the study; the median age was 38 years (IQR = 33-44) and 56.5% were female. Patients perceived physicians engaged in a high number of communication behaviors (mean = 3.80, range 1-5). A higher perceived general health status (P = 0.01), shorter distance to the health facility (P = 0.03) and lesser time spent at the health facility (P = 0.02) were associated with a higher number of perceived physician communication behaviors. Physician-patient relationship factors were not associated with physician communication behaviors. In addition, a higher number of perceived physician communication behaviors was associated with a very high likelihood of patients' attending the next HIV clinic [adjusted odds ratio (AOR): 1.89, 95% confidence interval (CI): 1.49-2.40], a lower likelihood of patients' missing an appointment (AOR: 0.75, 95% CI: 0.61-0.92) and missing cART medication (AOR: 0.68, 95% CI: 0.52-0.87).

Conclusion: Patients' perception of physician communication behaviors was found to be associated with their adherence to HIV care.