A Closer Look at Racism and Heterosexism in Medical Students' Clinical Decision-Making Related to HIV Pre-Exposure Prophylaxis (PrEP): Implications for PrEP Education.
A Closer Look at Racism and Heterosexism in Medical Students' Clinical Decision-Making Related to HIV Pre-Exposure Prophylaxis (PrEP): Implications for PrEP Education.
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DOI：
10.1007/s10461-017-1979-z
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发表时间：
2018-04
影响因子：
4.4
通讯作者：
Dovidio JF
中科院分区：
文献类型：
--
作者：
Calabrese SK;Earnshaw VA;Krakower DS;Underhill K;Vincent W;Magnus M;Hansen NB;Kershaw TS;Mayer KH;Betancourt JR;Dovidio JF
医疗保健提供者中的社会偏见可能会限制PrEP的获得。在这项对115名美国医学生的调查研究中，我们考察了偏见(种族主义和异性恋主义)与PrEP临床决策之间的关联，并探索了先前的PrEP教育作为潜在的缓冲。在观看了一名寻求PrEP的MSM患者的小插曲后，参与者报告了预期的患者行为(无公寓性行为、关系外性行为和依从性)、给患者开PrEP的意图、偏见和背景特征。种族主义影响临床决策的证据微乎其微。在非校正分析中，异性恋通过所有预期行为间接影响处方意向，被测试为平行中介。表现出更多异性恋倾向的参与者更强烈地预期风险行为和坚持问题的增加，这与较低的处方意向相关。无避孕套的性行为对背景特征的间接影响仍然显著。先前的学前教育没有缓冲任何间接影响。异性恋可能会影响对男男性行为者提供PrEP，应该在PrEP相关的医学教育中加以解决。
Social biases among healthcare providers could limit PrEP access. In this survey study of 115 US medical students, we examined associations between biases (racism and heterosexism) and PrEP clinical decision-making and explored prior PrEP education as a potential buffer. After viewing a vignette about a PrEP-seeking MSM patient, participants reported anticipated patient behavior (condomless sex, extra-relational sex, and adherence), intention to prescribe PrEP to the patient, biases, and background characteristics. Minimal evidence for racism affecting clinical decision-making emerged. In unadjusted analyses, heterosexism indirectly affected prescribing intention via all anticipated behaviors, tested as parallel mediators. Participants expressing greater heterosexism more strongly anticipated increased risk behavior and adherence problems, which were associated with lower prescribing intention. The indirect effect via condomless sex remained significant adjusting for background characteristics. Prior PrEP education did not buffer any indirect effects. Heterosexism may compromise PrEP provision to MSM and should be addressed in PrEP-related medical education.
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DOI：
10.1331/japha.2013.12202
发表时间：
2013-03
期刊：
Journal of the American Pharmacists Association : JAPhA
影响因子：
--
作者：
Dayer L;Heldenbrand S;Anderson P;Gubbins PO;Martin BC
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Martin BC
影响因子：
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影响因子：
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作者：
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Shelton, J. Nicole
DOI：
10.1097/qai.0000000000001182
发表时间：
2017-02-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
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作者：
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通讯作者：
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DOI：
10.1080/09540121.2016.1153595
发表时间：
2016-09-01
影响因子：
1.7
作者：
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