HIV/AIDS-related institutional mistrust among multiethnic men who have sex with men: Effects on HIV testing and risk behaviors.

Abstract

Objective: To investigate relationships between institutional mistrust (systematic discrimination, organizational suspicion, and conspiracy beliefs), HIV risk behaviors, and HIV testing in a multi-ethnic sample of men who have sex with men (MSM), and to test whether perceived susceptibility to HIV mediates these relationships for White and ethnic minority MSM. Methods: Participants were 394 MSM residing in Central Arizona (M age = 37 years). Three dimensions of mistrust were examined including Organizational Suspicion, Conspiracy Beliefs, and Systematic Discrimination. Assessments of sexual risk behavior, HIV testing, and perceived susceptibility to HIV were made at study entry (T1) and again six months later (T2). Results: There were no main effects of institutional mistrust dimensions or ethnic minority status on T2 risk behavior, but the interaction of Systematic Discrimination and Conspiracy Beliefs with minority status was significant such that higher levels of Systematic Discrimination and more Conspiracy Beliefs were associated with increased risk only among ethnic minority MSM. Higher levels of Systematic Discrimination was significantly related to lower likelihood for HIV testing, and the interaction of Organizational Suspicion with minority status was significant such that greater levels of Organizational Suspicion was related to less likelihood of having been tested for HIV among ethnic minority MSM. Perceived susceptibility did not mediate these relationships. Conclusion: Findings suggest that it is important to look further into the differential effects of institutional mistrust across marginalized groups, including sexual and ethnic minorities. Aspects of mistrust should be addressed in HIV prevention and counseling efforts.

Cultural Mistrust, Conspiracy Theories and Attitudes towards HIV Testing Among African Americans

“…First, none of the variables was significantly correlated with the major dependent variable, attitude towards HIV testing. These findings are contrary to the literature suggesting that cultural mistrust, medical mistrust and conspiracy theories are associated with lower odds of HIV testing [28]. There are a number of possible explanations for this lack of correlation.…”

Leveraging Social Media to Explore Black Women's Perspectives on HIV Pre-exposure Prophylaxis

“…Other research has demonstrated that medical mistrust and endorsement of counter-narratives are typically negatively associated with engagement in HIV treatment and prevention (e.g., HIV testing, condom use, HIV medication adherence and retention; Bogart & Bird, 2003; Bogart & Thorburn, 2005; Bogart, Wagner, Galvan, & Banks, 2010; Eaton et al, 2015; Hoyt et al, 2012). For example, endorsement of general HIV/ AIDS, government counter-narratives are associated with negative beliefs about condom use among African Americans (Bogart & Bird, 2003; Bogart & Thorburn, 2005).…”

A Qualitative Study of Medical Mistrust, Perceived Discrimination, and Risk Behavior Disclosure to Clinicians by U.S. Male Sex Workers and Other Men Who Have Sex with Men: Implications for Biomedical HIV Prevention

“…[11][12][13][14] A recent study of New York MSM found that although most had seen a clinical provider recently, 39 % did not disclose sexual activity with male partners, with lower rates among African American and Latino MSM. 15 Medical mistrust, [16][17][18][19] discrimination experiences, [18][19][20][21] conspiracy beliefs, 19,22,23 and concerns about disclosure may be particularly significant barriers to PrEP access among MSM of color, as demonstrated by a recent PrEP acceptability study among African American MSM. 24 Treatment mistrust and HIV conspiracy beliefs are also linked to sexual risk-taking and nonadherence to antiretroviral treatment 22,23 ; it is unknown how mistrust may now influence PrEP use.…”

“…34 Despite acknowledgement of medical mistrust, perceived discrimination, and disclosure difficulties among MSWs and other MSM, little research has considered differences in how MSWs experience these phenomena. Many comparative analyses of medical mistrust and disclosure among subgroups of MSM focus on differences by race and ethnicity, [15][16][17][18][19][20][21][22][23][24]35 rather than sex work. Earnshaw and colleagues have proposed a comprehensive model linking mistrust to HIV risk, 35 which suggests that intersecting stigmas (e.g., based on race, sexual orientation, sex work, or incarceration) combine to influence disparities in risk, screening, treatment, and survival.…”