The baseline evaluation is an opportunity for you to listen and learn about your patients’ lives, needs, and concerns, The relationship between patient and provider is important to a patient’s engagement in care.

CYNTHIA RIVERA, MD: I’m just really curious, Leandro, specifically what are some topics that you delve into further in your initial evaluation? 

LEANDRO MENA, MD: We want to make sure patients understand what it means to be HIV-infected and you know, how is the clinical management of HIV, the long-term management. I like to also allow an opportunity for the patient, you know to tell me what they’re most concerned about. Sometimes they say, well, I don’t think, you know anyone is going to want me like this now, and so again these are opportunities for you to use the information that they will give you as a motivation of why, them, you know receiving treatment and being adherent to medication. So I really like to make sure that I consider, you know, the concerns that the patients may have and the questions that they may have to make sure that in spite of that initial visit that’s included in the conversations that we will be having. 

DERRICK BUTLER, MD: Exactly. It keys into that whole team approach. The patient is part of the team, and making them feel part of it because they brought their concerns to the table, not just yours about you know, controlling their viral load or keeping their CD4 counts high, but you know for them that may not mean much, but like what you’re saying, you know, they want to know can I have kids? Can I, you know, share food with my family? You know, making sure they understand that these are things that once they get a grasp of and understand, that helps in terms of them buying into treatment. 

CYNTHIA RIVERA, MD: Any concerns or any advice that you have in helping make sure that these conversations go well? 

LEANDRO MENA, MD: You have to really make an effort to understand your patient, to sense where they are in terms of emotionally dealing with the diagnosis and where they are in terms of education and health literacy, and making sure that you come across as someone who cares, someone who relates, you know, that you show empathy you know for whatever situation they are, and also that you bring to them a sense of hope.

CYNTHIA RIVERA, MD: If you listen and take a good comprehensive sexual history, that’s when you can help prevent transmission through making sure that we educate on transmission either sexually or in our IV drug users. If we talk to them in a nonjudgmental fashion, we get a good history on substance use. We can discuss things like needle sharing and different modes of transmission that your patients may not be aware of. 

DERRICK BUTLER, MD: I mean the biggest advice I think is, just make sure you listen. When a patient feels heard, they feel more empowered versus being talked to.