Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb;105(2):e75-82.
doi: 10.2105/AJPH.2014.302322.

The role of stigma and medical mistrust in the routine health care engagement of black men who have sex with men

Lisa A Eaton  1 , Daniel D Driffin, Christopher Kegler, Harlan Smith, Christopher Conway-Washington, Denise White, Chauncey Cherry
Affiliations

The role of stigma and medical mistrust in the routine health care engagement of black men who have sex with men

Lisa A Eaton et al. Am J Public Health. 2015 Feb.

Abstract

Objectives: We assessed how health care-related stigma, global medical mistrust, and personal trust in one's health care provider relate to engaging in medical care among Black men who have sex with men (MSM).

Methods: In 2012, we surveyed 544 Black MSM attending a community event. We completed generalized linear modeling and mediation analyses in 2013.

Results: Twenty-nine percent of participants reported experiencing racial and sexual orientation stigma from heath care providers and 48% reported mistrust of medical establishments. We found that, among HIV-negative Black MSM, those who experienced greater stigma and global medical mistrust had longer gaps in time since their last medical exam. Furthermore, global medical mistrust mediated the relationship between stigma and engagement in care. Among HIV-positive Black MSM, experiencing stigma from health care providers was associated with longer gaps in time since last HIV care appointment.

Conclusions: Interventions focusing on health care settings that support the development of greater awareness of stigma and mistrust are urgently needed. Failure to address psychosocial deterrents will stymie progress in biomedical prevention and cripple the ability to implement effective prevention and treatment strategies.

PubMed Disclaimer

Figures

FIGURE 1—
FIGURE 1—
Mediation analysis investigating the relationship between health care stigma, global medical mistrust, and time since last physical examination among HIV-negative Black MSM: Atlanta, GA, 2012. Note. MSM = men who have sex with men. Total indirect effect = 0.05 (95% confidence interval = 0.01, 0.11. *P < .05; ***P < .001.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. Estimated HIV incidence in the United States, 2007–2010. HIV Surveillance Supplemental Report. 2012;17(4):1–26.
    1. Purcell DW, Johnson CH, Lansky A et al. Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. Open AIDS J. 2012;6:98–107. - PMC - PubMed
    1. Abdool Karim Q, Abdool Karim SS, Frohlich JA et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329(5996):1168–1174. - PMC - PubMed
    1. Grant RM, Lama JR, Anderson PL et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–2599. - PMC - PubMed
    1. Cohen MS, Chen YQ, McCauley M et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505. - PMC - PubMed

Publication types

MeSH terms