Collective AIDS activism and individuals' perceived self-advocacy in physician-patient communication

In a study of AIDS activism and communication patterns between people with HIV or AIDS and health care personnel, parallel persuasive processes are described between social or political activism and personal self‐advocacy. The analysis of public and private discourse leads to 3 interrelated conclusions about AIDS activist behaviours at the collective and individual levels: (a) greater patient education about the illness and treatment options is encouraged, (b) a more assertive stance toward health care is promoted, and mindful nonadherence is considered. Activists perceived that their self‐advocacy behaviors, in turn, impact the physician‐patient interaction. In communicative interactions, education allows patients to challenge the expertise of the physician, assertiveness allows them to confront paternalistic or authoritarian interactional styles, and mindful nonadherence allows them to reject treatment recommendations and offer reasons for doing so. Participants reported that physicians had mixed reactions to their self‐advocacy attempts.