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13-01-2022

Perceived discrimination, adherence to antiretroviral therapy, and HIV care engagement among HIV-positive black adults: the mediating role of medical mistrust

Tijdschrift:: Journal of Behavioral Medicine

Auteurs:: Lu Dong, Laura M. Bogart, Matt G. Mutchler, Sean J. Lawrence, David J. Klein, Mahlet Gizaw, Glenn J. Wagner

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Abstract

Perceived discrimination and medical mistrust are contributors to HIV inequities. The current study examined whether medical mistrust mediated the associations between perceived discrimination and adherence to antiretroviral therapy (ART) as well as care engagement in a sample of 304 Black adults living with HIV. Perceived discrimination and medical mistrust were measured using validated scales; ART adherence was electronically monitored for a month; care engagement was determined by medical record data. Results support significant total indirect effects from perceived discrimination (due to HIV-serostatus, race, sexual orientation) to ART adherence through three types of medical mistrust (towards healthcare organizations, one’s physician, and HIV-specific mistrust). The total indirect effects were also significant for care engagement and were largely driven by mistrust towards one’s own physician. Findings suggest interventions at the provider or healthcare organization levels should address medical mistrust to improve the health and well-being of Black Americans living with HIV.

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Titel: Perceived discrimination, adherence to antiretroviral therapy, and HIV care engagement among HIV-positive black adults: the mediating role of medical mistrust
Auteurs:: Lu Dong
Laura M. Bogart
Matt G. Mutchler
Sean J. Lawrence
David J. Klein
Mahlet Gizaw
Glenn J. Wagner
Publicatiedatum: 13-01-2022
DOI: https://doi.org/10.1007/s10865-021-00277-z
Uitgeverij: Springer US
Tijdschrift: Journal of Behavioral Medicine
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521

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