Patient–Provider Relationships and Antiretroviral Therapy Adherence and Durable Viral Suppression Among Women with HIV,Miami-Dade County,Florida,2021–2022

Abstract

Women with HIV in the United States are more negatively affected by adverse social determinants such as low education and poverty than men, and thus, especially need a supportive health care system. This cross-sectional study assessed the role of the patient–provider relationship on antiretroviral therapy (ART) adherence and durable viral suppression among women with HIV (WHIV) in Miami-Dade County, Florida. Patient–provider relationship was measured, in part, using the Health Care Relationship Trust Scale and Consumer Assessment of Health Care Providers and Systems. The survey was administered by telephone to women in the Ryan White Program June 2021–March 2022. Adherence was defined as 90% adherent on the average of three self-reported items. Lack of durable viral suppression was defined by at least one viral load ≥200 copies/mL among all tests conducted in a year. Logistic regression models were generated using backward stepwise modeling. Of 560 cis-gender women, 401 (71.6%) were adherent, and 450 (80.4%) had durable viral suppression. In the regression model, adherence was associated with higher patient–provider trust and provider communication as well as excellent perceived health, lack of significant depressive symptoms, no alcohol use within the last 30 days, and lack of transportation problems. In the regression model using provider as a random effect, durable viral suppression was associated with older age, Hispanic ethnicity, and lack of illegal drug use. While the results show that a strong patient–provider relationship facilitates ART adherence in WHIV, there was no association with durable viral suppression.