The Role of Cultural Distance Between Patient and Provider in Explaining Racial/ethnic Disparities in HIV Care

Overview

Journal Patient Educ Couns

Publisher Elsevier

Specialties Health Services
Nursing

Date 2011 Feb 12

PMID 21310581

Citations 27

Authors

Somnath Saha

David S Sanders

Philip Todd Korthuis

Jonathan A Cohn

Victoria L Sharp

Paul Haidet

Richard D Moore

Mary Catherine Beach

Affiliations

Soon will be listed here.

Abstract

Objective: We sought to evaluate whether cultural distance between patients and providers was associated with quality of care for people living with HIV/AIDS, and whether cultural distance helped explain racial/ethnic disparities in HIV care.

Methods: We surveyed 437 patients and 45 providers at 4 HIV clinics in the U.S. We examined the association of patients' perceived cultural distance from their providers with patient ratings of healthcare quality, trust in provider, receipt of antiretroviral therapy, medication adherence, and viral suppression. We also examined whether racial/ethnic disparities in these aspects of HIV care were mediated by cultural distance.

Results: Greater cultural distance was associated with lower patient ratings of healthcare quality and less trust in providers. Compared to white patients, nonwhites had significantly lower levels of trust, adherence, and viral suppression. Adjusting for patient-provider cultural distance did not significantly affect any of these disparities (p-values for mediation >.10).

Conclusion: Patient-provider cultural distance was negatively associated with perceived quality of care and trust but did not explain racial/ethnic disparities in HIV care.

Practice Implications: Bridging cultural differences may improve patient-provider relationships but may have limited impact in reducing racial/ethnic disparities, unless coupled with efforts to address other sources of unequal care.

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