This paper analyzes data collected through focus groups of patients at an outpatient AIDS clinic at a New York medical center. Seven focus groups were conducted with 42 HIV+ patients, and verbatim transcripts of focus group sessions were analyzed through a combination of ethnographic and content analysis. We examined patients' reports of interactions with and attitudes toward their providers and attempted to define what elements in the provider-patient relationship are necessary to enable patients to become more integrally involved in the management of their illness. Participants' statements emerged as consistent with three themes: (a) dynamics of provider-to-patient communication; (b) dynamics of patient-to-provider communication; and (c) dynamics of collaboration. Each of these themes is discussed in terms of its implications for creating patient-provider relationships based on mutual-participation, and requisites for effecting meaningful patient-provider partnerships are outlined.