You and your doctor

The relationship you establish with your specialist HIV doctor is very important.

It's important that you find the right kind of doctor for you. Other people who are HIV-positive (if you have friends who are positive or meet people through a support group) may be able to recommend a doctor, but building up a relationship with your doctor may take time. You may not develop a rapport with the first doctor you meet. Establishing a trusting relationship with your doctor is important if you are to feel empowered and in control of your use of treatments.

Your doctor should have good interpersonal skills. The level of knowledge your doctor has is clearly important too. An effective doctor should take the time to explain things to you, be sensitive to personal issues you raise, be a good listener and be able to provide you with a range of opinions.

All patients need their doctors to be open, frank and communicative – as well as honest when he or she does not know the answer to your questions.

You will need to be involved in your own care. Exactly what this means depends on the type of person you are. Some people will want to take a more active role in their care and treatment. They may have clear ideas about what kind of treatments they do or do not want to use. Other people are more inclined to look to their doctor for guidance.

Being prepared for your consultations is a joint responsibility. It may be helpful to keep asking questions until you understand something that is being explained to you. If you are likely to forget what your doctor tells you during the consultation, then it's a good idea to make notes. If you are likely to forget which questions you would like to ask, then write a letter or an email to your doctor with your questions and send it in advance of your appointment, or bring a written list with you to the appointment. It's also worth remembering that if you attend your clinic without an appointment, your regular doctor may not be available.

During the course of your HIV treatment and care there may occasionally be issues upon which you and your doctor do not agree. It's important that you learn how to manage these situations. If you become unhappy over a disagreement with your doctor, you could choose to invite a patient advocate (which some hospitals have) or a friend to help you communicate your feelings.

It is important to be honest with your doctor about the way you live your life. Knowing the facts helps your doctor to consider appropriate care and treatment for you. If, however, you feel unable to confide in your doctor about certain issues, there may be other staff in the department who you could talk to more easily.

Your HIV clinic notes are confidential and nobody - including other healthcare staff unless they are involved in your care - can see them without your consent. But there are limits to this confidentiality and medical records have been used in recent prosecutions for reckless transmission of HIV.

Maintaining contact with the same doctor can be extremely difficult, as they are usually very busy, and staff change from time to time. Remember though, that their time is no more valuable than your own. If getting access to your doctor is difficult, discuss ways of improving the situation. Would a short phone call or email enquiry be acceptable? You will need to be organised to get the most from your doctor's time. Learning about the roles of other staff at your treatment centre will also help you avoid using your doctor's time when another member of staff would be able to help, and can provide you with additional sources of support. For non-HIV-related medical problems, it might be more appropriate to see your GP.