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Medical Mistrust and the PrEP Cascade Among Latino Sexual Minority Men

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Abstract

Latino sexual minority men (SMM) have high HIV incidence rates but report low pre-exposure prophylaxis (PrEP) use. Medical mistrust predicts lower medical care use and could contribute to decreased PrEP engagement. This study examines how medical mistrust relates to the PrEP cascade among 151 Latino SMM aged 18–29. Logistic regressions were employed with medical mistrust predicting PrEP awareness, willingness, current use, and adherence. Greater medical mistrust was associated with decreased odds of all outcomes and may represent a barrier to PrEP engagement for Latino SMM. Further research should explore whether reducing medical mistrust among Latino SMM could increase PrEP engagement.

Resumen

Los hombres de sexualidad minoría latinos (HSML) tienen altas tasas de VIH, pero reportan bajo uso de profilaxis preexposición (PrEP). La desconfianza médica (DM) predice menor uso de atención médica y podría contribuir a menor uso de PrEP. Este estudio examina cómo la DM se relaciona con la cascada de PrEP entre 151 HSML. Se realizaron regresiones logísticas con DM prediciendo conocimiento, disposición, uso y adherencia de PrEP. Alta DM se asoció con menos probabilidad de todos los resultados y puede representar una barrera hacia PrEP. Futuras investigaciones deberían explorar si reduciendo la DM entre HSML aumenta compromiso con PrEP.

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Acknowledgements

David Rivera’s work on this project was supported by the National Institutes of Health award number 5 R25 GM058906.

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Authors and Affiliations

  1. Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA

    Devon Kimball, David Rivera & Aaron J. Blashill

  2. Department of Psychology, San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct., San Diego, CA, 92120, USA

    Manuel Gonzales IV & Aaron J. Blashill

Authors
  1. Devon Kimball
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  2. David Rivera
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  3. Manuel Gonzales IV
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  4. Aaron J. Blashill
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Contributions

All authors contributed to study design and conception. AB performed data collection and DK, MG, and AB contributed to data analysis. DK, DR, and MG wrote the first draft of the manuscript, and all authors contributed to manuscript edits. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Aaron J. Blashill.

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The authors declare that they have no conflict of interest.

Research Involving Human Participants and/or Animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (San Diego State University Institutional Review Board) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Kimball, D., Rivera, D., Gonzales, M. et al. Medical Mistrust and the PrEP Cascade Among Latino Sexual Minority Men. AIDS Behav 24, 3456–3461 (2020). https://doi.org/10.1007/s10461-020-02916-z

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  • DOI: https://doi.org/10.1007/s10461-020-02916-z

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