Laura M Bogart1, Glenn Wagner, Frank H Galvan, Denedria Banks. 1. Children's Hospital Boston/Harvard Medical School, Department of Medicine, Division of General Pediatrics, Boston, MA 02215, USA. laura.bogart@childrens.harvard.edu
Abstract
BACKGROUND: Medical mistrust is prevalent among African Americans and may influence health care behaviors such as treatment adherence. We examined whether a specific form of medical mistrust-HIV conspiracy beliefs (eg, HIV is genocide against African Americans)-was associated with antiretroviral treatment nonadherence among African American men with HIV. METHODS: On baseline surveys, 214 African American men with HIV reported their agreement with 9 conspiracy beliefs, sociodemographic characteristics, depression symptoms, substance use, disease characteristics, medical mistrust, and health care barriers. Antiretroviral medication adherence was monitored electronically for one month postbaseline among 177 men in the baseline sample. RESULTS: Confirmatory factor analysis revealed 2 distinct conspiracy belief subscales: genocidal beliefs (eg, HIV is manmade) and treatment-related beliefs (eg, people who take antiretroviral treatments are human guinea pigs for the government). Both subscales were related to nonadherence in bivariate tests. In a multivariate logistic regression, only treatment-related conspiracies were associated with a lower likelihood of optimal adherence at one-month follow-up (odds ratio = 0.60, 95% confidence interval = 0.37 to 0.96, P < 0.05). CONCLUSIONS: HIV conspiracy beliefs, especially those related to treatment mistrust, can contribute to health disparities by discouraging appropriate treatment behavior. Adherence-promoting interventions targeting African Americans should openly address such beliefs.
BACKGROUND: Medical mistrust is prevalent among African Americans and may influence health care behaviors such as treatment adherence. We examined whether a specific form of medical mistrust-HIV conspiracy beliefs (eg, HIV is genocide against African Americans)-was associated with antiretroviral treatment nonadherence among African American men with HIV. METHODS: On baseline surveys, 214 African American men with HIV reported their agreement with 9 conspiracy beliefs, sociodemographic characteristics, depression symptoms, substance use, disease characteristics, medical mistrust, and health care barriers. Antiretroviral medication adherence was monitored electronically for one month postbaseline among 177 men in the baseline sample. RESULTS: Confirmatory factor analysis revealed 2 distinct conspiracy belief subscales: genocidal beliefs (eg, HIV is manmade) and treatment-related beliefs (eg, people who take antiretroviral treatments are humanguinea pigs for the government). Both subscales were related to nonadherence in bivariate tests. In a multivariate logistic regression, only treatment-related conspiracies were associated with a lower likelihood of optimal adherence at one-month follow-up (odds ratio = 0.60, 95% confidence interval = 0.37 to 0.96, P < 0.05). CONCLUSIONS:HIV conspiracy beliefs, especially those related to treatment mistrust, can contribute to health disparities by discouraging appropriate treatment behavior. Adherence-promoting interventions targeting African Americans should openly address such beliefs.
Authors: Cynthia A Kleeberger; Jennifer Buechner; Frank Palella; Roger Detels; Sharon Riddler; Rebecca Godfrey; Lisa P Jacobson Journal: AIDS Date: 2004-03-05 Impact factor: 4.177
Authors: Mallory O Johnson; Sheryl L Catz; Robert H Remien; Mary Jane Rotheram-Borus; Stephen F Morin; Edwin Charlebois; Cheryl Gore-Felton; Rise B Goldsten; Hannah Wolfe; Marguerita Lightfoot; Margaret A Chesney Journal: AIDS Patient Care STDS Date: 2003-12 Impact factor: 5.078
Authors: Skai W Schwartz; Yuri Sebastião; Julie Rosas; Michelle R Iannacone; Philip R Foulis; W McDowell Anderson Journal: Sleep Breath Date: 2016-01-25 Impact factor: 2.816
Authors: Marya Gwadz; Charles M Cleland; Elizabeth Applegate; Mindy Belkin; Monica Gandhi; Nadim Salomon; Angela Banfield; Noelle Leonard; Marion Riedel; Hannah Wolfe; Isaiah Pickens; Kelly Bolger; DeShannon Bowens; David Perlman; Donna Mildvan Journal: AIDS Behav Date: 2015-10
Authors: Jane M Simoni; David Huh; Ira B Wilson; Jie Shen; Kathy Goggin; Nancy R Reynolds; Robert H Remien; Marc I Rosen; David R Bangsberg; Honghu Liu Journal: J Acquir Immune Defic Syndr Date: 2012-08-15 Impact factor: 3.731
Authors: Kristen Underhill; Kathleen M Morrow; Christopher Colleran; Richard Holcomb; Sarah K Calabrese; Don Operario; Omar Galárraga; Kenneth H Mayer Journal: J Urban Health Date: 2015-08 Impact factor: 3.671
Authors: Manya Magnus; Jane Herwehe; Michelli Murtaza-Rossini; Petera Reine; Damien Cuffie; DeAnn Gruber; Michael Kaiser Journal: AIDS Patient Care STDS Date: 2013-05 Impact factor: 5.078
Authors: David W Pantalone; Kimberly M Nelson; Abigail W Batchelder; Christopher Chiu; Hamish A Gunn; Keith J Horvath Journal: J Sex Res Date: 2020-02-20
Authors: Laura M Bogart; Matt G Mutchler; Bryce McDavitt; David J Klein; William E Cunningham; Kathy J Goggin; Bonnie Ghosh-Dastidar; Nikki Rachal; Kelsey A Nogg; Glenn J Wagner Journal: Ann Behav Med Date: 2017-12