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

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

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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