OBJECTIVES: To assess the impact of communication between physicians and patients living with HIV/AIDS on levels of treatment adherence and patient satisfaction. METHODS: In a previous survey at our teaching hospital in Thailand we found good adherence in 99% of patients, assessed by visual analogue scale. This qualitative study was conducted between November 2007 – January 2008. The research comprised direct observations of patient-health care provider encounters at the clinic and in-depth interviews with 14 key informants including patients and their spouses. Interview responses were recorded, transcribed and organized thematically based on emerging codes using an inductive analysis. Discussion with attending physicians, nurses, and pharmacists at the clinic was also incorporated as data triangulation.   RESULTS: Potential problems in the patient-provider communication included unfriendly welcoming or disgusted reactions; disclosure of confidential matters; and health care environment factors. Compared with their previous experiences at other health care facilities, the patients were very satisfied with genuine and empathetic providers at this site. Moreover, they perceived that the providers were more highly trained specialists with effective communication skills, which encouraged the patients to ask questions regarding their health. In addition, a hotline number was provided so the patients could contact the clinic whenever they encountered any health-related problems or needed assistance. Thus, a trusted therapeutic rapport was established with a positive impact on the patient-physician’s commitment to care which resulted a good adherence. CONCLUSIONS: Provider-patient communication contributes to patient satisfaction with medical treatment which is extremely important in HIV/AIDS care. As numerous issues facilitate or inhibit constructive relationships between providers and patients, it is essential for doctors to be aware of their power when dealing with patients, particularly in this consumer empowerment era. Good communication is essential to good practice of medicine and its rewards are immeasurable for both patients and providers.