Negotiating Trust: A Grounded Theory Study of Interpersonal Relationships Between Persons Living With HIV/AIDS and Their Primary Health Care Providers

This grounded theory study is an exploration of long-term interpersonal relationships between patients and their primary health care providers, including physicians and nurse practitioners, in an urban outpatient HIV/AIDS clinic. Many providers believe that the positive interpersonal relationship enhances the health care experience for the patient, but there is a scarcity of research in this area. Persons who are patients were interviewed (N = 14) to look at these relationships from their points of view and develop theory to guide clinicians in forming such relationships. Theoretical sampling was used to find patients in this clinic population involved in long-term relationships with their providers. Open-ended interviews were conducted. These data were coded using the grounded theory method of constant comparative analysis. A basic process of negotiating trust was identified. Trust in these relationships is a state that is dynamic, volatile, and constantly renegotiated during the trajectory of the relationship through time. The trusting relationship is personally supportive for patients and may be a factor in the satisfaction found among health care providers in this clinical field despite the nature of this epidemic.