People Living With HIV Communicate Less With Health Care Providers

Results from the third wave of the Positive Perspectives (PP3) study, conducted on people living with HIV across the world,1 highlight a potential disconnect in the patient-provider relationship among these individuals. Although a large number of those surveyed trusted their health care provider (HCP), many also felt unheard by providers during appointments, leading to them not going to their HCP for adjustments to their antiretroviral therapy (ART) regimen. Individuals not trusting their HCP could have effects on adherence in this population.

Individuals with HIV reported communication gaps with health care providers. | Image credit: bongkarn - stock.adobe.com

The PP3 study was created and conducted by community representatives and sponsored by ViiV Healthcare. The interim analysis of the cross-sectional survey included 698 people from 16 countries, with a goal of 3000 people across 29 countries when it is completed, including people living with HIV, youth living with HIV, and personnel in patient organizations focused on HIV. The survey aims to improve care, outcomes, and treatment of HIV through the use of communication. The included patients were from Argentina, Australia, Austria, Canada, Chile, Colombia, Ireland, Italy, Mexico, Poland, South Africa, South Korea, Switzerland, Taiwan, United Kingdom, and the US. These interim results were presented at the AIDSImpact Conference, held in Morocco from May 26 to May 28.

The initial results of the survey showed that 80% of the surveyed participants trusted their HCP to care for them. However, 47.5% of the participants felt they were not heard by their HCP. This led to 39.7% of the participants stating they did not make decisions with their HCP when it came to changing their ART regimen. This could become a problem, due to individuals also reporting they were happier with their treatment when they made decisions with their HCP.

Patients reported they were less likely to skip doses when satisfied with their ART regimen, with these patients also reporting good health outcomes overall. The long-term effects of ART were a concern for 53% of those surveyed, along with weight gain related to treatment (48.6%) and the daily dose of medication (43.2%). A total of 93.7% of the surveyed patients were aware that undetectable viral load equaled untransmittable disease, but only 58.1% believed this. Further, 31.1% of those surveyed could not explain undetectable equals unstransmittable to others. Positive psychosocial outcomes were associated with those who believed in undetectable equaling untransmittable, including enjoyment of sex and reduced stigma both from internal and external means.

This survey builds on the results from previous waves of the survey. Positive Perspectives 2 (PP2), which was released in 2021, reported results on how patients felt about their treatment. Sicty-eight percent of those individuals were worried about the long-term effects of medicine for HIV, 57% were concerned about needing to take more medicine as they got older, and 65% wanted to be more involved in their HIV treatment.2 PP2 also reported that only 44% of participants were completely satisfied with their medication and 23% reported suboptimal health. Similary to PP3, the participants in PP2 thought there were barriers to discussing concerns with their HCP, with 88% of men who have sex with women, 59% of men who have sex with men, and 73% of women with HIV reporting that they felt these barriers.

These results indicate a breakdown in communication between patients with HIV and their HCP, which could affect both psychosocial outcomes, as well as adherence and satisfaction with treatment through ART. As results from this survey continue to come in, it is important to start addressing this breakdown in communication to help improve outcomes in this population. This can include starting digital interventions3 and other noted strategies4 that can help to mitigate poor outcomes due to lack of communication or disparities in health care.

"The [PP3] data highlight the need for healthcare professionals to have meaningful conversations with their patients that go beyond just viral suppression - conversations that empower people living with HIV to confidently share their needs, preferences, and goals with their medical providers. Ensuring that people with HIV fully understand critical concepts like ‘Undetectable = Untransmittable’ is essential to achieving this kind of communication, so we can improve the quality of HIV care and support people with HIV to live healthier, more fulfilling lives," said David Hardy, MD, clinical professor of family medicine, Division of Street Medicine at Keck School of Medicine of The University of Southern California.1

References

1. ViiV Healthcare positive perspectives 3 study finds widespread communication barriers: half of people living with HIV feel unheard by healthcare providers despite high trust. News release. ViiV Healthcare. May 27, 2025. Accessed June 6, 2025. https://viivhealthcare.com/hiv-news-and-media/news/press-releases/2025/may/positive-perspectives-survey/

2. Positive perspectives study, wave 2 results report. ViiV Healthcare. Updated July 2021. Accessed June 6, 2025. https://viivhealthcare.com/content/dam/cf-viiv/viivhealthcare/en_GB/files/211203-updated-pp2-report-v9.0.pdfhttps://viivhealthcare.com/content/dam/cf-viiv/viivhealthcare/en_GB/files/211203-updated-pp2-report-v9.0.pdf

3. Bonavitacola J. Enhancing HIV outcomes in adolescents can be done through evidence-based interventions. AJMC®. January 10, 2025. Accessed June 6, 2025. https://www.ajmc.com/view/enhancing-hiv-outcomes-in-adolescents-can-be-done-through-evidence-based-interventions

4. Daoud O, Gladstein JE, Brixner D, O’Brochta S, Naik S. Health disaprities in HIV care and strategies for improving equitable access to care. 2025;31(1 suppl):S3-S12. doi:10.37765/ajmc.2025.89687