The Effect of Conspiracy Beliefs and Trust on HIV Diagnosis, Linkage, and Retention in Young MSM with HIV

Gillman, Jason; Davila, Jessica A.; Sansgiry, Shubhada; Parkinson-Windross, Diana; Miertschin, Nancy; Mitts, Beau; Henley, Charles E.; Giordano, Thomas P.

doi:10.1353/hpu.2013.0012

Cited by 25 publications

(20 citation statements)

References 19 publications

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“…Undoubtedly, the history of unethical treatment including serious physical and emotional abuse of race-minority populations in medical studies in the US and abroad has given way to a general mistrust of medicine and medical establishments for many individuals. These beliefs are prominent in the HIV treatment landscape [23, 39, 40]. As HIV prevention moves more towards biomedical approaches to slowing the epidemic, developing strong relationships and improving the general social standing of medical establishments, in particular in marginalized communities, will be critical for product scale up.…”

Section: Discussionmentioning

confidence: 99%

Stigma and Conspiracy Beliefs Related to Pre-exposure Prophylaxis (PrEP) and Interest in Using PrEP Among Black and White Men and Transgender Women Who Have Sex with Men

et al. 2017

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The HIV/AIDS epidemic in the US continues to persist, in particular, among race, sexual orientation, and gender minority populations. Pre-exposure prophylaxis (PrEP), or using antiretroviral medications for HIV prevention, is an effective option, but uptake of PrEP has been slow. Sociocultural barriers to using PrEP have been largely underemphasized, yet have the potential to stall uptake and, therefore, warrant further understanding. In order to assess the relationships between potential barriers to PrEP (i.e., PrEP stigma and conspiracy beliefs), and interest in PrEP, Black men and transgender women who have sex with men (BMTW, N = 85) and White MTW (WMTW, N = 179) were surveyed at a gay pride event in 2015 in a large southeastern US city. Bivariate and multivariate logistic regression analyses were completed to examine factors associated with PrEP interest. Among the full sample, moderate levels of PrEP awareness (63%) and low levels of use (9%) were observed. Believing that PrEP is for people who are promiscuous (stigma belief) was strongly associated with lack of interest in using PrEP, and individuals who endorsed this belief were more likely to report sexual risk taking behavior. Conspiracy beliefs related to PrEP were reported among a large minority of the sample (42%) and were more frequently reported among BMTW than WMTW. Given the strong emphasis on the use of biomedical strategies for HIV prevention, addressing sociocultural barriers to PrEP access is urgently needed and failure to do so will weaken the potential benefits of biomedical prevention.

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Section: Discussionmentioning

confidence: 99%

Stigma and Conspiracy Beliefs Related to Pre-exposure Prophylaxis (PrEP) and Interest in Using PrEP Among Black and White Men and Transgender Women Who Have Sex with Men

et al. 2017

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“…Previous qualitative and quantitative findings highlight the importance of selecting the right messenger (or “Communication Source”) as HIV conspiracy theories and myths and misperceptions exacerbate the level of research distrust present in the community; this was especially notable among Black MSM [31]. Many Black participants stated that historical events, such as the Tuskegee experiment, influenced their decision to participate in studies [31, 32].…”

Section: Discussionmentioning

confidence: 99%

“…Many Black participants stated that historical events, such as the Tuskegee experiment, influenced their decision to participate in studies [31, 32]. Some Black MSM explicitly expressed their distrust for researchers; however, they stated that the inclusion of Black researchers would motivate their participation, particularly if the lead researcher was Black and served as an advocate for them [32].…”

Section: Discussionmentioning

confidence: 99%

From (Un)Willingness to InvolveMENt: Development of a Successful Study Brand for Recruitment of Diverse MSM to a Longitudinal HIV Research

Frew

Williams

Sanchez

et al. 2013

International Journal of Population Research

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Background HIV continues to be a major concern among MSM, yet Black MSM have not been enrolled in HIV research studies in proportionate numbers to White MSM. We developed an HIV prevention research brand strategy for MSM. Methods Questionnaires and focus groups were conducted with 54 participants. Descriptive statistics and chi-square analyses were performed and qualitative data were transcribed and content analyzed to identify common themes. Results Formative research results indicated that younger Black MSM (18–29 years) were less likely to think about joining prevention studies compared to older (≥30 years) Black MSM (x2 = 5.92, P = 0.015). Qualitative and quantitative results indicate four prominent themes related to brand development: (1) communication sources (message deliverer), (2) message (impact of public health messaging on perceptions of HIV research), (3) intended audience (underlying issues that influence personal relevance of HIV research), and (4) communication channels (reaching intended audiences). Conclusion The findings highlight the importance of behavioral communication translational research to effectively engage hard-to-reach populations. Despite reservations, MSM in our formative study expressed a need for active involvement and greater education to facilitate their engagement in HIV prevention research. Thus, the brand concept of “InvolveMENt” emerged.

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“…For example, African American men who believed that people who take ART are human guinea pigs for the government were less likely to adhere to treatment at optimal levels for viral suppression. Null associations between belief in conspiracies and behaviors have been found in samples that include racial/ethnic groups other than (and in addition to) African Americans, and that have indicated higher endorsement of conspiracy beliefs among African Americans, especially compared to Whites (Clark et al, 2008; Gillman et al, 2013; Westergaard et al, 2014). Thus, mistrust among African Americans in particular may have greater implications for health behaviors and consequent disparities.…”

Section: Introductionmentioning

confidence: 99%

Medical mistrust among social network members may contribute to antiretroviral treatment nonadherence in African Americans living with HIV

Bogart

Wagner

Green

et al. 2016

Social Science & Medicine

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Rationale African Americans living with HIV are less likely to adhere to antiretroviral treatment (ART) compared to other racial/ethnic groups. Medical mistrust is thought to be a factor in this disparity. Objective We examined (1) whether exposure to HIV conspiracy beliefs, a specific type of HIV-related mistrust (about the origins and treatment of HIV) in social networks is associated with ART nonadherence among African Americans living with HIV; and (2) the characteristics of individuals who discuss HIV-related mistrust in the social networks of African Americans living with HIV. Methods At baseline and 6- and 12-months post-baseline, 175 African Americans living with HIV on ART completed egocentric social network assessments, from which we assessed the structure and composition of their personal networks (the social context immediately surrounding them). HIV-related mistrust was operationalized with an indicator of whether any social network member had expressed HIV conspiracy beliefs to the participant. Daily medication adherence was monitored electronically. Results At baseline, 63% of participants agreed with at least one conspiracy belief, and 55% reported hearing at least one social network member (“alter”) express conspiracy beliefs. In a multivariate linear repeated measures regression, expression of conspiracy beliefs by similar others in the network (in terms of age, gender, HIV status, sexual orientation, and race/ethnicity) was associated with ART nonadherence (i.e., percentage of prescribed doses taken). In a multivariate logistic regression, expression of conspiracy beliefs was more likely among social network members who were HIV-positive, who knew the participants’ serostatus, and with whom participants interacted frequently, and less likely among more well-connected social network members. Conclusion HIV-related mistrust in the network may be most influential when expressed by similar others who may be HIV-positive themselves.

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The Effect of Conspiracy Beliefs and Trust on HIV Diagnosis, Linkage, and Retention in Young MSM with HIV

Cited by 25 publications

References 19 publications

Stigma and Conspiracy Beliefs Related to Pre-exposure Prophylaxis (PrEP) and Interest in Using PrEP Among Black and White Men and Transgender Women Who Have Sex with Men

Stigma and Conspiracy Beliefs Related to Pre-exposure Prophylaxis (PrEP) and Interest in Using PrEP Among Black and White Men and Transgender Women Who Have Sex with Men

From (Un)Willingness to InvolveMENt: Development of a Successful Study Brand for Recruitment of Diverse MSM to a Longitudinal HIV Research

Medical mistrust among social network members may contribute to antiretroviral treatment nonadherence in African Americans living with HIV

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