Medical Mistrust Is Related to Lower Longitudinal Medication Adherence Among African-American Males with HIV

Published in: Journal of Health Psychology, 2014

Posted on RAND.org on January 01, 2014

by Sannisha K. Dale, Laura M. Bogart, Glenn Wagner, Frank H. Galvan, David J. Klein

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Research Question

  1. Is medical mistrust among African-American males with HIV related to their lower rates of medication adherence?

African-Americans living with HIV show worse health behaviors (e.g. medication adherence) and outcomes (e.g. viral suppression) than do their White counterparts. In a 6-month longitudinal study, we investigated whether medical mistrust among African-American males with HIV (214 enrolled, 140 with longitudinal data) predicted lower electronically monitored antiretroviral medication adherence. General medical mistrust (e.g. suspicion toward providers), but not racism-related mistrust (e.g. belief that providers treat African-Americans poorly due to race), predicted lower continuous medication adherence over time (b = -.08, standard error = .04, p = .03). Medical mistrust may contribute to poor health outcomes. Intervention efforts that address mistrust may improve adherence among African-Americans with HIV.

Key Finding

Medical mistrust among African-American males with HIV predicts lower medication adherence over time and may help to explain disparities in medication adherence rates (as well as related HIV health outcomes) between African-Americans and other racial/ethnic groups.

Recommendation

Intervention efforts at the societal, medical system, and individual levels targeting medical mistrust may help to reduce health disparities and improve medication adherence for African-Americans with HIV.

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