Conspiracy Beliefs Among African Americans Deter Condom Use

Significant numbers of African Americans believe in conspiracy theories about AIDS, and black men with such beliefs are less likely to use condoms as a precaution against spreading the HIV virus, according to a study issued today by the RAND Corporation and Oregon State University.

The study was supported by the National Institute of Child Health and Human Development and appears in the Feb. 1 edition of the Journal of Acquired Immune Deficiency Syndromes. It is the most thorough examination of the types of AIDS conspiracy theories held by African Americans, and is the first to also examine the relationship of those beliefs to the use of condoms. More men than women believe in the conspiracy theories, the study found.

Researchers conducted a national telephone survey of a scientifically selected random sample of 500 African Americans ages 15-44 from around the United States. Those surveyed were asked a series of questions about whether they agreed or disagreed with specific HIV/AIDS myths. The survey of African Americans found that:

• About 59 percent agreed with the statement that “a lot of information about AIDS is being held back from the public.”
• 53 percent agreed that “there is a cure for AIDS, but it is being withheld from the poor.”
• Nearly 27 percent agreed that “AIDS was produced in a government laboratory.”
• About 16 percent agreed that AIDS was created by the government to control the black population.
• About 15 percent agreed that AIDS is a form of genocide against African Americans.

“These beliefs are widespread and demonstrate substantial mistrust of the health care system among African Americans,” said Laura Bogart, a RAND Health psychologist and lead author of the study. “For HIV prevention efforts to be successful, these beliefs need to be discussed openly, because people who do not trust the health care system may be less likely to listen to public health messages. This includes messages about HIV prevention.”

African American men who agreed with conspiracy myths were significantly less likely to report that they use condoms regularly. This was not the case among African American women.

Bogart and co-author Sheryl Thorburn, an associate professor of public health at Oregon State University, said the new study suggests that distrust of the health care system may be one factor contributing to the AIDS epidemic among African Americans. While African Americans make up about 12 percent of the U.S. population, they accounted for more than half of the new HIV and AIDS cases diagnosed in 2002.

“This is one of the first studies to show that these beliefs about HIV/AIDS may be affecting behavior,” said Thorburn, principal investigator for the study. “Our results suggest that these beliefs may have a negative impact on preventive practices. We need more open discussion about these beliefs.”

Researchers believe that HIV/AIDS myths stem from the well-documented cases of racial discrimination that led to substandard health care for African Americans during much of American history, particularly the infamous Tuskegee syphilis study.

During the 40-year-long Tuskegee study that ended in 1972, poor African American men in Alabama were denied treatment for syphilis while being told they were being treated for “bad blood.” The goal of the study was to document the natural progression of the disease, uninterrupted by treatment.

“Our findings show that it’s necessary to tailor a public health message to a community,” Bogart said. “No one billboard message is going to work for an entire city. Public health practitioners need to openly address these conspiracy beliefs and create culturally appropriate messages for African Americans.”

Use of peer educators to disseminate HIV prevention messages has proven successful within the gay community and may be one way to address conspiracy beliefs among African Americans.

Bogart said future research should examine conspiracy beliefs among members of populations at high risk for HIV, such as African American gay and bisexual men, as well as assess whether the beliefs influence how HIV-positive African Americans follow their treatment regimes. Researchers also need to investigate ways to effectively counteract conspiracy beliefs.

RAND Health is the nation’s largest independent health policy research organization, with a broad research portfolio that focuses on health care quality, costs, and delivery, among other topics.