Adherence and communication: Reports from a study of HIV general practice

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Since 1995 the expression of HIV disease in Australia has changed considerably in the direction of chronic illness. The presence of effective but highly toxic treatments for HIV - with low tolerability, and requiring a high level of adherence - creates a difficult problematic for general practitioners who prescribe them. Not the least of these difficulties is how to begin to identify what is going on for the patient in order to engage with it for the purposes of enhancing adherence, and - more generally - health and wellbeing. These reports examine some of the ways in which practitioners are addressing this problematic, both by their own account (as described in Pills in Practice), and in terms of actual instances of exchange with patients (as shown in Compliance Supportive Communication). HIV general practice is unusual in the sense that its practitioners often share - or have some understanding of - the socially produced experience of stigma and shame that attends many of the practices relating to the conditions that are seen in practice. This creates unique forms of clinical practice, from which there is much to learn. We have used this opportunity to describe and evaluate some of the forms of practice and communication that have emerged in Sydney in this context. Through discussion and reflection, the various strengths of these different techniques might be drawn upon to promote better practice.
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Race, Kane
McInnes, David
Wakeford, Elisabeth
Kleinert, Veronica
McMurchie, Marilyn
Kidd, Michael
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download Compliance Supportive Communication.pdf 821.55 KB Adobe Portable Document Format
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