Medical mistrust is related to lower longitudinal medication adherence among African-American males with HIV

Abstract

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 towards 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, se=.04, p=.03). Medical mistrust may contribute to poor health outcomes. Intervention efforts that address mistrust may improve adherence among African-Americans with HIV.

Treatment perceptions in patients with asthma: Synthesis of factors influencing adherence

“…This is because cultural effects on treatment necessity beliefs and concerns are not directly linked to study country, as these can vary between countries, and between disparate cultural groups within a country [86,87]. For example, some minority groups distrust medication which translate to higher rates of non-adherence than their counterparts of a different cultural background but of the same nationality [88], while certain cultures may show lower adherence rates than others because patients have more difficulties in accessing healthcare services [87].…”

Medical mistrust as a key mediator in the association between perceived discrimination and adherence to antiretroviral therapy among HIV-positive Latino men

“…Our prior research has found medical mistrust to be related to ART medication nonadherence among HIV-positive African American men (Bogart et al, 2010; Dale et al, 2016), which has been confirmed as well among general samples of people living with HIV (Thrasher, Earp, Golin, & Zimmer, 2008). This present study extends the previous findings by focusing on a sample of HIV-positive Latino men and also by indicating the role that medical mistrust can serve as a mediator in the association between discrimination and adherence to ART.…”

“…However, studies (not including Latinos) using the same scale as used in the present study have also found moderate levels of medical mistrust but with higher levels than those observed in the present research. These occurred in studies among HIV-positive African American men ( M = 2.66) (Dale et al, 2016) and a mixed sample of African American and White cardiac patients ( M = 2.29) (with the African American patients reporting higher endorsement of all the mistrust items than the White patients) (LaVeist et al (2000). It is not immediately clear why the Latino participants of the present study reported less mistrust than the ethnic groups in other studies that used the same medical mistrust measure.…”

“…Among HIV-positive African Americans and Latinos not on antiretroviral therapy (ART), physician mistrust was found to be negatively associated with readiness for ART (Gwadz et al, 2014). Medical mistrust has also been associated with lower longitudinal medication adherence among HIV-positive African American males (Dale et al, 2016). …”

Do Persons Living with HIV Continue to Fill Prescriptions for Antiretroviral Drugs during a Gap in Care? Analysis of a Large Commercial Claims Database

“…11–15 These factors may all play a role in failing to fill ARV drug prescriptions during overly long intervals between clinic visits. While nonadherence factors may be important, a less recognized reason for failing to fill ARV drug prescriptions, during a gap in care, might be a lack of access.…”