When the Patient is Absent in Patient-Centered Communication Training: A Discursive Analysis of How Medical Students Learn to Interact with Patients.

: Patient-centered communication is an ideal for undergraduate medical education and has been for decades. However, medical students often find the patient-centered approach challenging. The present study finds a possible discordance between formal intentions of a medical curriculum and the corresponding learning environment.

Episodic Relatedness in Socioeconomically Disadvantaged Families Where a Parent has Multiple Diagnoses.

There is a strong association between social relationships and health. In this article, we ask how a view of social relationships played out in time can help to nuance the role of patients' social networks in their healthcare-seeking behavior. We investigate this link by exploring the dynamics of relatedness in socioeconomically vulnerable young families with a multimorbid parent and their extended networks.

'If you had taken the lead…' - a qualitative study of patients with chronic conditions and their perspective in clinical encounters with medical students.

Objectives: To explore what patients with chronic conditions emphasize as important in the patient-medical student conversation, and how the patients' experiences relate to trust.

Methods: Twenty-one video-recorded sessions of patients' feedback in simulation-based communication courses for medical students were observed, transcribed, analyzed inductively and organized into three themes.

Results: In the patients' feedback, three aspects were emphasized as important relating to trust: a) when the medical student relates medical information to the patient's lifeworld, b) when the student leads the patient throughout the conversation, and c) when the patient gets emotional support from the student.

Vietnamese women's struggle to access antiretroviral drugs in a context of free treatment.

This qualitative study aims to explore how HIV positive women living in a northern province of Vietnam experience seeking antiretroviral (ARV) treatment in the public health system, and how they address obstacles encountered along the way. Despite the fact that antiretroviral drugs were freely provided, they were not always accessible for women in need. A variety of factors at the population and health system level interacted in ways that often made access to ARV drugs a complicated and time-consuming process.

The ambivalence of stigma and the double-edged sword of HIV/AIDS intervention in Burkina Faso.

This article analyses the causes of HIV stigmatisation in Burkina Faso as perceived by people living with HIV/AIDS (PLHIV) and people working in AIDS-related Community Based Organisations (CBOs). Stigmatisation continues to be a pressing issue when dealing with HIV/AIDS in Sub-Saharan Africa. The article is based on direct observation of HIV-related practices within 20 CBOs in Burkina Faso, as well as semi-structured interviews or focus group discussions with 72 PLHIV and 90 professionals and volunteers working in CBOs.

Pursuing treatment and moral worth: HIV-infected women in a northern province of Vietnam living with antiretroviral therapy.

There is a need to understand how social and cultural expectations of being a woman shape the challenges women face when trying to access antiretroviral therapy (ART) and to continue the treatment over time. Based on a 7-month prospective study of 15 HIV-infected women, the particular challenges met by these women in northern Vietnam are discussed in this article. We argued that, by taking ART to maintain their health and to fulfill their responsibilities to family and community, the women managed to reclaim the "moral worth" they had lost as a result of having HIV infection.

Antiretroviral therapy: unmet need and associated socio-demographic characteristics among HIV-positive women in Haiphong, Vietnam.

In Vietnam, ARV access has been scaled up since 2005 in high HIV prevalence areas in order to meet increasing demands for HIV treatment. This paper aims to estimate ARV unmet need and its associated socio-demographic characteristics among HIV-positive women in Haiphong, Vietnam. A cross-sectional study using structured questionnaires and CD4 cell count was conducted with 353 HIV-positive women recruited from groups of people living with HIV/AIDS (PLWHA), by snowball technique through member of PLWHA groups and the local AIDS management system (Provincial AIDS Center (PAC)).

Factors associated with the failure to seek HIV care and treatment among HIV-positive women in a northern province of Vietnam.

This cross-sectional survey examines the utilization of HIV care and treatment services after HIV diagnosis among women in Vietnam and describes factors that may be associated with failure in seeking services. From May 2007 to November 2007, we conducted structured interviews with 353 HIV-positive women living a Haiphong, a northern province of Vietnam. The women were recruited through a network of people living with HIV/AIDS (HPN+) by means of snowball sampling and through the local, governmental HIV registration system (Provincial AIDS Centre [PAC]).

Tests for life chances: CD4 miracles and obstacles in Uganda.

This article discusses the relationship between technologies, socialities and inequities based on case material from a recent study about the first generation of people living with ART - Antiretroviral Therapy - in Uganda. The authors discuss how the diagnostic technologies of HIV tests, 'CD4 counts', and weight measuring produce results and numbers that are appropriated by people living with HIV to reflect upon their lives, bodies and relationships and hence influence their socialities and subjectivities. It is argued that because treatment programmes and especially their associated technologies vary greatly in Uganda, the programmes themselves introduce inequity in the already unequal landscape of HIV patients.

Finding a path through the health unit: practical experience of Ugandan patients.

Finding one's way through a health facility is not necessarily an easy task for Ugandan patients. Our understanding of how people succeed in doing so, and of the obstacles they encounter on their way, is incomplete if we focus only on the cognitive level of the clinical encounter. Much research in public health and medical anthropology implicitly works with the notion that agency is located in the mind and that cognitive understanding is a precondition for practice.