Department of Medicine, University of Washington, Seattle, USA.
UW Center for AIDS Research, Harborview Medical Center, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104-2499, USA.
AIDS Behav. 2020 Apr;24(4):1170-1180. doi: 10.1007/s10461-019-02746-8.
Evidence suggests priorities differ between patients in HIV care and their providers regarding topics most important to address in care. At five U.S. sites, we asked patients and providers to prioritize 25 potential topic areas to address during routine visits, and invited patients to discuss selection rationale. Patients (n = 206) and providers (n = 17) showed high discordance in rank order priorities (X (24, 223) = 71.12; p < 0.0001). Patients ranked social domains such as HIV stigma highly; a higher proportion of providers prioritized substance use domains. HIV stigma was a higher priority for patients in care fewer than 6 years (Fisher's exact p = 0.0062), nonwhite patients (Fisher's exact p = 0.0114), and younger patients (Fisher's exact p = 0.0281). Patients' priorities differed between men and women (X (24, 188) = 52.89; p < 0.0001), white race vs. other races (X (24, 206) = 48.32; p = 0.0023), and Latinos vs. non-Latinos (X (24, 206) = 48.65; p = 0.0021). Interviews (n = 79) revealed perceived impact of social context on health and health behaviors.
有证据表明，HIV 护理中的患者及其护理人员在护理中最重要的议题上存在优先事项的差异。在美国的五个地点，我们要求患者和护理人员对 25 个潜在的话题领域进行优先排序，以在常规就诊中讨论，同时邀请患者讨论选择的理由。患者（n=206）和提供者（n=17）在优先级排序上存在高度不一致（X(24,223)=71.12;p<0.0001）。患者将 HIV 耻辱感等社会领域排在很高的位置；而更多的提供者则将重点放在物质使用领域。在护理时间不足 6 年的患者（Fisher 精确检验 p=0.0062）、非白人患者（Fisher 精确检验 p=0.0114）和年轻患者（Fisher 精确检验 p=0.0281）中，HIV 耻辱感的优先级更高。患者的优先事项因性别（X(24,188)=52.89;p<0.0001）、种族（X(24,206)=48.32;p=0.0023）和拉丁裔与非拉丁裔（X(24,206)=48.65;p=0.0021）而异。访谈（n=79）揭示了社会背景对健康和健康行为的影响。
