The ANRS-Ipergay trial, an opportunity to use qualitative research to understand the perception of the “participant”-physician relationship
Marion Di Ciaccio
(1, 2, 3)
,
Christel Protière
(1, 3)
,
Daniela Rojas Castro
(2, 1, 4, 5)
,
Marie Suzan-Monti
(1, 3)
,
Julie Chas
(6)
,
Laurent Cotte
(7)
,
Martin Siguier
(8)
,
Eric Cua
(9)
,
Bruno Spire
(1, 3)
,
Jean-Michel Molina
(10)
,
Marie Préau
(2, 1)
1
SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD -
Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
2 GRePS - Groupe de Recherche en Psychologie Sociale
3 ORS PACA - Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille]
4 Mission Innovation Recherche Expérimentation - AIDES [Pantin, France]
5 Programme Recherche Communautaire - Coalition Internationale Sida [Pantin, France]
6 CHU Tenon [AP-HP]
7 Hôpital de la Croix-Rousse - Service des maladies infectieuses et tropicales [CH Lyon Sud - HCL]
8 Génétique et Ecologie des Virus, Génétique des Virus et Pathogénèse des Maladies Virales
9 Hôpital l'Archet
10 Service des Maladies Infectieuses et Tropicales
2 GRePS - Groupe de Recherche en Psychologie Sociale
3 ORS PACA - Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille]
4 Mission Innovation Recherche Expérimentation - AIDES [Pantin, France]
5 Programme Recherche Communautaire - Coalition Internationale Sida [Pantin, France]
6 CHU Tenon [AP-HP]
7 Hôpital de la Croix-Rousse - Service des maladies infectieuses et tropicales [CH Lyon Sud - HCL]
8 Génétique et Ecologie des Virus, Génétique des Virus et Pathogénèse des Maladies Virales
9 Hôpital l'Archet
10 Service des Maladies Infectieuses et Tropicales
Marion Di Ciaccio
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- Fonction : Auteur correspondant
- PersonId : 21159
- IdHAL : marion-di-ciaccio
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Christel Protière
- Fonction : Auteur
- PersonId : 21097
- IdHAL : christel-protiere
- ORCID : 0000-0002-5602-9617
- IdRef : 077935489
Daniela Rojas Castro
- Fonction : Auteur
- PersonId : 750021
- IdHAL : daniela-rojas-castro
- ORCID : 0000-0002-5379-1438
Marie Suzan-Monti
- Fonction : Auteur
- PersonId : 21154
- IdHAL : marie-suzan-monti
- ORCID : 0000-0003-2507-2863
- IdRef : 253119545
Laurent Cotte
- Fonction : Auteur
- PersonId : 937111
Bruno Spire
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- PersonId : 21084
- IdHAL : bruno-spire
- ORCID : 0000-0002-3546-8020
- IdRef : 09825846X
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Marie Préau
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- Fonction : Auteur correspondant
- PersonId : 171105
- IdHAL : preau-marie
- ORCID : 0000-0002-6239-1671
- IdRef : 084340525
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Résumé
The ANRS-IPERGAY trial consisted in providing sexual activity-based antiretroviral prophylaxis for HIV prevention (PrEP) with a package of prevention tools (counselling, condoms, HIV and sexually transmitted infections' screening) to highly exposed HIV-negative men who have sex with men (MSM). Few data exist concerning the patient-physician relationship in the particular context of PrEP, where physicians discuss sexual behaviours with MSM who are not classic patients, in that consultation is for prevention purposes, not for illness. This study took place during the open-label extension of ANRS-IPERGAY trial when all participants received PrEP. In this qualitative study, we examined how physicians perceived their relationship with participants in the ANRS-IPERGAY trial. Of all 30 physicians involved in the trial who were contacted by email to participate in an interview about their opinions and perceptions of ANRS-IPERGAY 18 volunteered to participate in the current sub-study. We performed a vertical analysis for each interview to identify the extract in each physician's discourse concerning their relationship with MSM participants, and conducted a horizontal analysis to construct the thematic tree and subsequently investigate differences and similitudes between themes. An analysis of all physicians' discourses showed that the participant-physician relationship during the trial could be described through 4 themes: (i) personal experience of the relationship, (ii) trust and non-judgement, (iii) positive relational climate and (iv) influence of physician's characteristics (age, gender, etc.) on relationship. We found that the particular context of PrEP led some physicians to adopt a patient-as-partner approach during consultations rather than a paternalist or hierarchical approach. Indeed, the close follow-up provided by the trial and the active role of patients in their own prevention care trajectory, are more compatible with the patient-as-partner approach. The prescription of PrEP may lead to an evolution in patient-physician relationships and may even modify the professional identity of physicians.
Domaines
PsychologieFormat du dépôt | Notice |
---|---|
Type de dépôt | Article dans une revue |
Titre |
en
The ANRS-Ipergay trial, an opportunity to use qualitative research to understand the perception of the “participant”-physician relationship
|
Résumé |
en
The ANRS-IPERGAY trial consisted in providing sexual activity-based antiretroviral prophylaxis for HIV prevention (PrEP) with a package of prevention tools (counselling, condoms, HIV and sexually transmitted infections' screening) to highly exposed HIV-negative men who have sex with men (MSM). Few data exist concerning the patient-physician relationship in the particular context of PrEP, where physicians discuss sexual behaviours with MSM who are not classic patients, in that consultation is for prevention purposes, not for illness. This study took place during the open-label extension of ANRS-IPERGAY trial when all participants received PrEP. In this qualitative study, we examined how physicians perceived their relationship with participants in the ANRS-IPERGAY trial. Of all 30 physicians involved in the trial who were contacted by email to participate in an interview about their opinions and perceptions of ANRS-IPERGAY 18 volunteered to participate in the current sub-study. We performed a vertical analysis for each interview to identify the extract in each physician's discourse concerning their relationship with MSM participants, and conducted a horizontal analysis to construct the thematic tree and subsequently investigate differences and similitudes between themes. An analysis of all physicians' discourses showed that the participant-physician relationship during the trial could be described through 4 themes: (i) personal experience of the relationship, (ii) trust and non-judgement, (iii) positive relational climate and (iv) influence of physician's characteristics (age, gender, etc.) on relationship. We found that the particular context of PrEP led some physicians to adopt a patient-as-partner approach during consultations rather than a paternalist or hierarchical approach. Indeed, the close follow-up provided by the trial and the active role of patients in their own prevention care trajectory, are more compatible with the patient-as-partner approach. The prescription of PrEP may lead to an evolution in patient-physician relationships and may even modify the professional identity of physicians.
|
Auteur(s) |
Marion Di Ciaccio
1, 2, 3
, Christel Protière
1, 3
, Daniela Rojas Castro
2, 1, 4, 5
, Marie Suzan-Monti
1, 3
, Julie Chas
6
, Laurent Cotte
7
, Martin Siguier
8
, Eric Cua
9
, Bruno Spire
1, 3
, Jean-Michel Molina
10
, Marie Préau
2, 1
1
SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD -
Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
( 541536 )
- Faculté de Médecine - Site Timone - 27 Bd Jean Moulin 13385 Marseille Cedex 05.
- France
2
GRePS -
Groupe de Recherche en Psychologie Sociale
( 49955 )
- Université Lyon 2 - Institut de Psychologie 5 avenue Pierre Mendès-France - 69676 BRON cedex
- France
3
ORS PACA -
Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille]
( 521833 )
- France
4
Mission Innovation Recherche Expérimentation -
AIDES [Pantin, France]
( 555703 )
- France
5
Programme Recherche Communautaire -
Coalition Internationale Sida [Pantin, France]
( 555704 )
- France
6
CHU Tenon [AP-HP]
( 328304 )
- 4 Rue de la Chine, 75020 Paris
- France
7
Hôpital de la Croix-Rousse -
Service des maladies infectieuses et tropicales [CH Lyon Sud - HCL]
( 555705 )
- France
8
Génétique et Ecologie des Virus, Génétique des Virus et Pathogénèse des Maladies Virales
( 81451 )
- Université Paris Diderot, Institut Universitaire d'Hématologie (IUH), Hôpital Saint Louis 1 avenue Claude Vellefaux 75010 Paris
- France
9
Hôpital l'Archet
( 300155 )
- 151 Route de Saint-Antoine de Ginestière, 06200 Nice
- France
10
Service des Maladies Infectieuses et Tropicales
( 197258 )
- 1, avenue Claude Vellefaux 75010 Paris
- France
|
Langue du document |
Anglais
|
Vulgarisation |
Non
|
Comité de lecture |
Oui
|
Audience |
Internationale
|
Date de publication |
2018-05-30
|
Volume |
30
|
Numéro |
sup2
|
Page/Identifiant |
41-47
|
Nom de la revue |
|
Domaine(s) |
|
Collaboration/Projet |
|
Mots-clés |
en
ANRS-IPERGAY trial, Patient-physician relationship, PrEP, patient-as-partner
|
DOI | 10.1080/09540121.2018.1468013 |
Pubmed Id | 29848004 |
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