Understanding Patient–Provider Relationships: A Qualitative Study of Rural HIV Care in a Low-Prevalence Mountain West State in the United States

Supportive relationships between people living with HIV (PLWH) and their health care providers are crucial for treatment adherence and communication about health needs. This study explored key elements of patient-provider relationships (PPRs) among PLWH in a predominantly rural, Mountain West state with a low HIV prevalence. We analyzed in-depth interviews conducted with 17 PLWH. We identified 4 key themes related to PPR: (a) providers' limited competencies in HIV and lesbian, gay, bisexual, transgender and queer issues, (b) patients' desire for empathetic and nonjudgmental care, (c) patients' experiences of dismissal or dehumanization by providers or the health care system, and (d) experiences and fear of stigma. Our findings underscore the role that PPR plays in addressing or exacerbating barriers for PLWH in rural areas, emphasizing the need for both interpersonal (e.g., provider-focused) and structural interventions to increase providers' HIV knowledge, decrease stigma, and foster positive PPR.