| There is much more to your relationship with your | | | | Internet or TV, ask your provider aboutthem. It may |
| HIVspecialist than medical appointments, discussing | | | | also help you to bring a friend, family member,or |
| labresults, and medication prescriptions. Your | | | | partner with you to your appointments to help |
| partnership withyour provider is your #1 "weapon" in | | | | youremember what was discussed. |
| your fight with HIV. Inorder to remain healthy, you | | | | In my own practice with HIV positive patients, I |
| will need to have trust andconfidence in your | | | | have hadmany, many patients approach the first |
| provider. The decisions that you makeabout your | | | | several visits as a |
| care are very important ones. | | | | "trial". I do not consider this to be threatening |
| Approach your initial meeting with the provider as if | | | | orinsulting in any way. In fact, it is to be |
| youare "interviewing" him or her for the position. | | | | commended,because it shows that the patient is |
| Askquestions about his or her background and | | | | very willing to be anactive part of his healthcare. I |
| experience andapproach to treatment (conservative, | | | | feel that my willingness tospend extra time with |
| "canned" approach vs.willingness to make a "custom" | | | | patients and really get to know themas people, and |
| treatment plan with you). Youshould feel that the | | | | get to know what is going on in their lives,has helped |
| provider is non-judgemental and willingto listen to and | | | | me to provide better care to them.I remember |
| discuss your treatment ideas and goals withyou. The | | | | oneyoung man who was moving to my city from the |
| provider's role is to educate you so that togetheryou | | | | west coast. Hecame in with his mother and sister for |
| can make informed and knowledgeable decisions, and | | | | a "tour" of theoffice. It was clear from the beginning |
| he orshe should be flexible enough to listen to and | | | | that he wasconsidering 3 different sites for his HIV |
| adjust toyour needs. If your questions are met with | | | | care, and that hewas "interviewing" me. The meeting |
| resistance orhostility, this is a sign that you need to | | | | lasted for over an hour,and he asked most of the |
| be wary andseriously consider if you will be able to | | | | questions that I have brought up inthis post. My |
| establish atrusting, therapeutic relationship with this | | | | willingness to listen to him and to discusswhat was |
| person. | | | | important to him is what won him over, and |
| Be honest with the provider. In HIV care, the | | | | heinitiated and continued his care with me. It turns |
| provider needsto really know you as a person. All | | | | out thathe had a bad experience with a provider in |
| aspects of yourlifestyle are important to your care. | | | | the pastregarding starting HIV medications. His CD4 |
| Be honest about sexualpractices, the use of alcohol | | | | cell count |
| and recreational drugs, dailyhabits, your support | | | | (T-Cells) had been in the 190-250 range for several |
| system (family, friends, domesticpartners), how you | | | | years,and his provider was insisting that he must |
| feel about having HIV and takingmedications, and | | | | startmedications. The patient tried to express his |
| about any other treatments that you areusing or are | | | | concerns, andwas pretty much told what he "had to |
| considering (such as vitamins, herbs,supplements, | | | | to". The provider didnot listen to the patient. |
| acupuncture, massage, etc.). If you feel thatthe | | | | My approach was different. Idiscussed the |
| provider is judgemental and that you have to hold | | | | progression of HIV disease with him, thecurrent |
| backcertain information or "tell them what they want | | | | Department of Health and Human Services (DHHS) |
| to hear",then you need to continue searching for the | | | | Guidelines for the treatment of HIV/AIDS- these |
| right provider. | | | | arerules:([ NOT entGL.pdf), and gave him the |
| You need to be totally honest with your provider | | | | informationthat he needed to make an informed |
| andcomfortable asking him or her questions, even if | | | | decision. He discussedhis feelings and opinions with |
| they arepersonal and embarrassing to you. | | | | me. He felt well, led anactive life (work, volunteer |
| Consider a situation where you might be having | | | | activities, social life), wasin a monogamous, stable |
| troubletaking your HIV medications (maybe you are | | | | relationship with his domesticpartner, ate right, |
| having sideeffects, have a new work schedule, or | | | | exercised regularly, got plenty ofsleep, and did not |
| are dealing withstressful events in your life). You | | | | smoke, drink alcohol, or use recreationaldrugs. He was |
| need to be able toopenly and honestly discuss these | | | | very knowledgeable about the side effects |
| issues with your provider,instead of saying what you | | | | andlong-term toxicities of the medications, and did |
| think they want to hear. Inreality, a good HIV | | | | not want totake them. We agreed that he was |
| specialist wants to hear what is reallygoing on with | | | | making a reasonable,informed choice, and that we |
| you so that they can help you to stick to | | | | would briefly discuss the issueon every visit, and that |
| yourtreatment plan, remain health, and prevent | | | | he would consider takingmedications only if he |
| complications. | | | | became symptomatic of HIV disease |
| Do not be afraid to ask questions and take notes. | | | | (began not to feel well). This approach encouraged |
| Beforeyour appointments, write down your questions | | | | totalhonesty from the patient, and it helped me to |
| and concerns,and take notes so that you can | | | | provide thebest care for him. |
| remember what you are told. | | | | The bottom line is that you and your HIV provider |
| It is OK to ask for clarification of unclear or | | | | must worktogether as a team to fight your HIV. You |
| confusingexplanations or medical terms - Keep asking | | | | need to becomfortable with each other and with |
| until youunderstand. The provider should be willing and | | | | each other's approachto dealing with your treatment. |
| able toexplain things so that you can understand | | | | This is a decision that youare making for life - so |
| them. If you havequestions about something that | | | | make it a good one!!! |
| you have heard from a friend,read, seen on the | | | | |