Medical Mistrust and Adherence to Care Among a Heterogeneous Cohort of Women Living with HIV, Followed in a Large, U.S. Safety Net Clinic

Lunthita M Duthely, Alex P Sanchez-Covarrubias, Varsha Prabhakar, Megan R Brown, Tanya E S Thomas, Emily K Montgomerie, JoNell E Potter, Lunthita M Duthely, Alex P Sanchez-Covarrubias, Varsha Prabhakar, Megan R Brown, Tanya E S Thomas, Emily K Montgomerie, JoNell E Potter

Abstract

Purpose: To explore the relationship between medical mistrust, as measured by the Group-Based Medical Mistrust (GBMM) scale, and HIV care adherence among a cohort of minority women receiving care in a U.S. safety net clinic. Methods: English-, Spanish-, and Haitian Creole (Creole)-speaking patients with a recent history of nonadherence to care were surveyed. Results: English speakers endorsed the highest level of mistrust, followed by Spanish speakers and Creole speakers. Creole speakers endorsed lower mistrust, lower suspicion of providers, and lower levels of "perceived health care disparities." Higher mistrust was associated significantly with lower medication adherence, and lower rates of viral suppression (nonsignificant). Conclusion: Understanding perceptions of medical care and the relationship to HIV care adherence is an important step to addressing negative health outcomes for ethnic minority women with HIV. Clinical Trial Registration Number: NCT03738410.

Keywords: HIV/AIDS; adherence; clinics; medical mistrust; racial minority.

Conflict of interest statement

No competing financial interests exist.

© Lunthita M. Duthely et al., 2021; Published by Mary Ann Liebert, Inc.

References

    1. HIV Surveillance Report, 2017. Available at Accessed April 8, 2021.
    1. QuickFacts. Miami city, Florida; Miami-Dade county, Florida. Available at Accessed April 8, 2021.
    1. Pellowski JA, Price DM, Allen AM, et al. . The differences between medical trust and mistrust and their respective influences on medication beliefs and ART adherence among African-Americans living with HIV. Psychol Health. 2017;32:1127–1139.
    1. Zhang C, McMahon J, Leblanc N, et al. . Association of medical mistrust and poor communication with HIV-related health outcomes and psychosocial wellbeing among heterosexual men living with HIV. AIDS Patient Care STDS. 2020;34:27–37.
    1. Kalichman SC, Eaton L, Kalichman MO, et al. . Medication beliefs mediate the association between medical mistrust and antiretroviral adherence among African Americans living with HIV/AIDS. J Health Psychol. 2017;22:269–279.
    1. Kalichman SC, Eaton L, Kalichman MO, et al. . Race-based medical mistrust, medication beliefs and HIV treatment adherence: test of a mediation model in people living with HIV/AIDS. J Behav Med. 2016;39:1056–1064.
    1. Bogart LM, Wagner GJ, Green HDJr., et al. . Medical mistrust among social network members may contribute to antiretroviral treatment nonadherence in African Americans living with HIV. Soc Sci Med. 2016;164:133–140.
    1. Relf MV, Pan W, Edmonds A, et al. . Discrimination, medical distrust, stigma, depressive symptoms, antiretroviral medication adherence, engagement in care, and quality of life among women living with HIV in North Carolina: a mediated structural equation model. J Acquir Immune Defic Syndr. 2019;81:328–335.
    1. Brincks AM, Shiu-Yee K, Metsch LR, et al. . Physician mistrust, medical system mistrust, and perceived discrimination: associations with HIV care engagement and viral load. AIDS Behav. 2019;23:2859–2869.
    1. Byrd WM, Clayton LA. Race, medicine, and health care in the United States: a historical survey. J Natl Med Assoc. 2001;93:11S–34S.
    1. Whetten K, Reif S, Whetten R, et al. . Trauma, mental health, distrust, and stigma among HIV-positive persons: implications for effective care. Psychosom Med. 2008;70:531–538.
    1. Savitt TL. The use of blacks for medical experimentation and demonstration in the old south. J South Hist. 1982;48:331–348.
    1. Farmer P. Aids and accusation: Haiti and the geography of blame. Berkeley: University of California Press, 1992, pp. 352. ISBN 0-520-07701-6.
    1. Vercammen KA, McClain AC, Tucker KL, et al. . The association between baseline acculturation level and 5-year change in adiposity among Puerto Ricans living on the mainland United States. Prev Med Rep. 2019;13:314–320.
    1. Housten AJ, Hoover DS, Correa-Fernández V, et al. . Associations of acculturation with English- and Spanish-Language health literacy among Bilingual Latino adults. Health Lit Res Pract. 2019;3:e81–e89.
    1. Schwartz SJ, Unger JB, Zamboanga BL, et al. . Rethinking the concept of acculturation: implications for theory and research. Am Psychol. 2010;65:237–251.
    1. Deyo RA, Diehl AK, Hazuda H, et al. . A simple language-based acculturation scale for Mexican Americans: validation and application to health care research. Am J Public Health. 1985;75:51–55.
    1. Lee S, Nguyen HA, Tsui J. Interview language: a proxy measure for acculturation among Asian Americans in a population-based survey. J Immigr Minor Health. 2011;13:244–252.
    1. Corral I, Landrine H. Acculturation and ethnic-minority health behavior: a test of the operant model. Health Psychol. 2008;27:737–745.
    1. Biswas S, Dinh D, Lucas M, et al. . Impact of limited English proficiency on presentation and clinical outcomes of patients undergoing primary percutaneous coronary intervention. Eur Heart J Qual Care Clin Outcomes. 2020;6:254–262.
    1. Kim EJ, Kim T, Paasche-Orlow MK, et al. . Disparities in hypertension associated with limited English proficiency. J Gen Intern Med. 2017;32:632–639.
    1. Jacobs ZG, Prasad PA, Fang MC, et al. . The association between limited English proficiency and sepsis mortality. J Hosp Med. 2019;14:E1–E7.
    1. Duthely LM, Sanchez-Covarrubias AP, Mohamed AB, et al. . A multilingual, culturally competent mobile health intervention to improve treatment adherence among women living with HIV: protocol for a randomized controlled trial. JMIR Res Protoc. 2020;9:e17656.
    1. Thompson HS, Valdimarsdottir HB, Winkel G, et al. . The Group-Based Medical Mistrust Scale: psychometric properties and association with breast cancer screening. Prev Med. 2004;38:209–218.
    1. Shelton RC, Winkel G, Davis SN, et al. . Validation of the Group-Based Medical Mistrust Scale among urban black men. J Gen Intern Med. 2010;25:549–555.
    1. Valera P, Boyas JF, Bernal C, et al. . A validation of the Group-Based Medical Mistrust Scale in formerly incarcerated Black and Latino men. Am J Mens Health. 2018;12:844–850.
    1. Dale SK, Bogart LM, Wagner GJ, et al. . Medical mistrust is related to lower longitudinal medication adherence among African-American males with HIV. J Health Psychol. 2016;21:1311–1321.
    1. Pellowski JA, Price DM, Allen AM, et al. . The differences between medical trust and mistrust and their respective influences on medication beliefs and ART adherence among African-Americans living with HIV. Psychol Health. 2017;32:1127–1139.
    1. Wilson IB, Lee Y, Michaud J, et al. . Validation of a new three-item self-report measure for medication adherence. AIDS Behav. 2016;20:2700–2708.
    1. Hall MB, Vos P, Bess JJ, et al. . Cervical cancer screening behaviors and perceptions of medical mistrust among rural black and white women. J Health Care Poor Underserved. 2018;29:1368–1385.
    1. Lopez-Cevallos DF, Harvey SM, Warren JT. Medical mistrust, perceived discrimination, and satisfaction with health care among young-adult rural Latinos. J Rural Health. 2014;30:344–351.
    1. Williamson LD, Bigman CA. A systematic review of medical mistrust measures. Patient Educ Couns. 2018;101:1786–1794.
    1. Jandorf L, Cooperman JL, Stossel LM, et al. . Implementation of culturally targeted patietn navigation system for screening colonoscopy in a direct referral system. Health Educ Res. 2013;28:803–815.
    1. Ramos SR, Warren R, Shedlin M, et al. . A framework for using eHealth interventions to overcome medical mistrust among sexual minority men of color living with chronic conditions. Behav Med. 2019;45:166–176.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere