HIV/AIDS conspiracy beliefs and intention to adopt preexposure prophylaxis among black men who have sex with men in Los Angeles

Abstract

In the United States, black men who have sex with men (MSM) are the group most affected by the HIV/AIDS epidemic. Pre-Exposure Prophylaxis (PrEP) is an important new HIV prevention strategy that may help reduce new HIV infections among black MSM. This analysis examined the association between HIV/AIDS conspiracy beliefs and intentions to adopt PrEP among 224 black MSM. The likelihood of adopting PrEP was assessed and more than half (60%) of the study population indicated a high intention to adopt PrEP. HIV/AIDS genocidal and treatment-related conspiracies were assessed using scales previously validated with black MSM. Almost two-thirds (63%) endorsed at least one of eight HIV/AIDS conspiracy beliefs presented. In multivariable analyses, black MSM who agreed with the genocidal or treatment-related conspiracy beliefs scales had a lower intention to adopt PrEP (AOR = 0.73, 95% CI = 0.54, 0.99 and AOR = 0.36, 95% CI = 0.23, 0.55, respectively). Our findings indicate that pre-existing HIV/AIDS conspiracy beliefs may deter some black MSM from adopting PrEP. We suggest strategies PrEP implementers may want to employ to address the influence that HIV/AIDS conspiracy beliefs may have on the adoption of PrEP among black MSM, a population disproportionately affected by HIV/AIDS.

Long‐term retention in pre‐exposure prophylaxis care among men who have sex with men and transgender women in the United States

“…Structural, social, behavioural and clinical factors may undermine retention in PrEP care. Barriers may include medication and monitoring costs , access to care , medical mistrust , stigma related to sexual orientation , low self‐perceived HIV risk , lack of motivation and limited provider knowledge and willingness to prescribe PrEP , as well as personal and community stigma and promiscuity stereotypes regarding PrEP users.…”

Next-Generation HIV Pre-Exposure Prophylaxis Preferences Among Men Who Have Sex with Men Taking Daily Oral Pre-Exposure Prophylaxis

“…9 Black and Hispanic MSM are dramatically underrepresented at every level of the PrEP care continuum, including uptake, retention in care, and adherence. [10][11][12][13] Prior research shows that these disparities persist even after structural barriers are addressed. 14 Focused research and public health interventions informed by structural barriers, including racism and the historical abuses of communities of color by medical institutions, are urgently needed to promote PrEP use and reduce HIV transmission among MSM of color.…”

“…14 Focused research and public health interventions informed by structural barriers, including racism and the historical abuses of communities of color by medical institutions, are urgently needed to promote PrEP use and reduce HIV transmission among MSM of color. 13,15,16 Ongoing development of the next generation of PrEP formulations has the potential to reduce barriers to uptake, adherence, and retention in care. Nonoral forms of PrEP currently in development include long-acting injectables (LAIs), rectal microbicides (RMs), antibody infusions (AIs), and subdermal implants (SIs).…”

HIV Conspiracy Theory Belief or Institutional Mistrust? A Call for Disentangling Key Concepts

“…4 Although there has been a nationwide decrease in HIV diagnoses since 2010, there have also been spikes in diagnoses within black and Latinx populations, indicative of what some presume to be a lack of awareness regarding prevention measures such as PrEP, postexposure prophylaxis, and treatment as prevention (i.e., undetectable status and viral suppression). 5 Individuals belonging to this population are likewise more disposed to encounter social stigma as it may relate to their HIV-positive status, as well as face more frequent barriers to the HIV care continuum. 6 Past and recent studies on the effects of HIV conspiracy theory beliefs largely target black men-black sexual minority men in particular; the former is a population that has historically been subjected to unethical treatment in the name of research (as with the Tuskegee syphilis experiment).…”

“…7 Arguably, transgenerational trauma from years of subjugation has shown to have an association with institutional mistrust and HIV conspiracy theory endorsement today. 5 Yet therein lies the crux of the problematic underpinning of past and current research on this particular topic. HIV conspiracy theory belief and institutional mistrust are terms that are often conflated even though separate scales exist to measure both independently (the LaVeist Medical Mistrust Index, the Hoofnagle AIDS Denialism Scale, the Bogart and Thorburn HIV Conspiracy Theory Belief Scale, etc.).…”