Physician Mistrust, Medical System Mistrust, and Perceived Discrimination: Associations with HIV Care Engagement and Viral Load

Overview

Journal AIDS Behav

Specialty Infectious Diseases

Date 2019 Mar 18

PMID 30879211

Citations 30

Authors

Ahnalee M Brincks

Karen Shiu-Yee

Lisa R Metsch

Carlos Del Rio

Robert P Schwartz

Petra Jacobs

Georgina Osorio

James L Sorensen

Daniel J Feaster

Affiliations

Soon will be listed here.

Abstract

Medical mistrust is an important risk factor for many health outcomes. For individuals with HIV and substance use co-morbidities, mistrust may influence engagement with health care, and affect overall health and transmission risk. Medical mistrust can be measured by an individual's mistrust of his/her physician, or mistrust of the medical system. This study examined both types of mistrust among 801 substance-using individuals with uncontrolled HIV infection. The aims were to determine how physician mistrust, medical system mistrust, and discrimination experiences were associated with engagement in HIV primary care. Findings indicated higher levels of physician mistrust, but not medical system mistrust, were associated with a longer time since the last visit to an HIV provider. Longer time since seeing an HIV care provider was associated with higher viral load. This study refines our understanding of the relationship between mistrust and HIV care engagement for a large, diverse sample of substance-using individuals.

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