Emotional Communication in HIV Care: An Observational Study of Patients’ Expressed Emotions and Clinician Response

Jenny Park, Somnath Saha, Dingfen Han, Stéphanie De Maesschalck, Richard Moore, Todd Korthuis, Debra Roter, Amy Knowlton, Tanita Woodson, Mary Catherine Beach

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Emotional support is essential to good communication, yet clinicians often miss opportunities to provide empathy to patients. Our study explores the nature of emotional expressions found among patients new to HIV care, how HIV clinicians respond to these expressions, and predictors of clinician responses. Patient-provider encounters were audio-recorded, transcribed, and coded using the VR-CoDES. We categorized patient emotional expressions by intensity (subtle ‘cues’ vs. more explicit ‘concerns’), timing (initial vs. subsequent), and content (medical vs. non-medical). Emotional communication was present in 65 of 91 encounters. Clinicians were more likely to focus specifically on patient emotion for concerns versus cues (OR 4.55; 95% CI 1.36, 15.20). Clinicians were less likely to provide space when emotional expressions were repeated (OR 0.32; 95% CI 0.14, 0.77), medically-related (OR 0.36; 95% CI 0.17, 0.77), and from African American patients (OR 0.42; 95% CI 0.21, 0.84). Potential areas for quality improvement include raising clinician awareness of subtle emotional expressions, the emotional content of medically-related issues, and racial differences in clinician response.

Original languageEnglish (US)
Pages (from-to)2816-2828
Number of pages13
JournalAIDS and behavior
Issue number10
StatePublished - Oct 1 2019


  • HIV
  • Patient-centeredness
  • Patient-provider communication
  • Quality

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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