Could empathy help treat HIV?
A new, systematic review suggests that HIV patients that receive non-judgmental, empathetic care from their primary health care providers are more likely to adhere to their life-saving drug regimes.
A new qualitative, systematic review study, led by researchers at Rutgers University (NJ, USA), has observed that patients with HIV have an increased likelihood of commencing and continuing disease treatment, if their primary care providers demonstrate empathy, understanding and non-judgmental attitudes towards them.
HIV/AIDS is a serious public health concern responsible for the deaths of over 34 million individuals worldwide. Continuous, lifesaving treatment – such as antiretroviral therapy – and HIV care engagement are critical to improving the health of patients living with HIV. However, individuals with HIV often discontinue, or do not seek out in the first instance, HIV care and therapy.
This systematic review aimed to evaluate the qualitative experiences of individuals with HIV, and HIV healthcare providers, with the US healthcare system, to identify barriers of HIV patients’ access to healthcare that is necessary for reducing HIV transmission and HIV-related mortality.
The review evaluated studies that had compiled data on the qualitative experiences of individuals, aged 18—65, with HIV, with the US healthcare systems, practices, processes and their healthcare providers (physicians, nurses, pharmacists, amongst others). All included studies were independently reviewed for methodological quality and data from them was compiled using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI).
This review covered 41 studies, primarily published between 2005 and 2017, and a total of 1597 HIV patients and HIV healthcare providers.
Meta-synthesis was employed to generate findings summarizing patients’ attitudes towards their HIV care. These findings suggest that patients were more likely to adhere to their care regimes if they received empathetic, non-stigmatized care from their primary health care providers. Patients also desired greater help to better understand their illness treatments and active involvement of their healthcare providers in their transitions and in securing resources.
Further, researchers noted that patients desired ‘one-stop’ service locations that concurrently provided patients with connections to psychological support and health insurance, for example; these may contribute to patients staying engaged with their healthcare regimes.
Andrea Norberg, lead study author and Executive Director of the François-Xavier Bagnoud Center at Rutgers School of Nursing (NJ, USA), commented: “Today, HIV is considered a chronic, treatable condition. However, this study found that many patients continue to view it as a death sentence.”
Norberg continued: “We know that people who are knowledgeable about HIV, who are engaged in care and taking antiretroviral therapy medications remain relatively healthy. Our challenge is to reach those people diagnosed with HIV and who are not retained or engaged in ongoing care. In the United States, this is approximately 49 percent of the 1.1 million people diagnosed.”
In the study, the authors concluded: “The synthesized findings illustrate clear quality indicators for primary care practice, emphasizing the patient-provider-care team partnership and shared decision making that is holistic, takes into account a patient's whole life, responsibilities and stressors, and reframes HIV associated misperceptions/myths.”
Norberg A, Nelson J, Holly C et al. Experiences of HIV-infected adults and healthcare providers with healthcare delivery practices that influence engagement in US primary healthcare settings: a qualitative systematic review. JBI Database System. Rev. Implement. Rep. 17(6): 1154-1228 (2019);