HIV-Related Medical Mistrust, HIV Testing, and HIV Risk in the National Survey on HIV in the Black Community
HIV-Related Medical Mistrust, HIV Testing, and HIV Risk in the National Survey on HIV in the Black Community
复制标题
DOI：
10.1080/08964289.2019.1585324
复制
发表时间：
2019-04-03
影响因子：
2.3
通讯作者：
Ojikutu, Bisola O.
中科院分区：
文献类型：
--
作者：
Bogart, Laura M.;Ransome, Yusuf;Ojikutu, Bisola O.
美国黑人受到艾滋病毒差异的极大影响，表现出高度的医疗不信任，包括艾滋病毒阴谋论，这是一种对艾滋病毒起源和治疗的不信任。2002-2003年对美国黑人的一项全国性调查发现，48%的人认为“艾滋病毒是一种人造病毒。“然而，这种信念在多大程度上仍然普遍存在是未知的。此外，艾滋病阴谋信念与更大的艾滋病风险有关，但也与更高的检测可能性有关，迄今为止还没有研究试图解释这些看似矛盾的发现。我们从美国黑人社区艾滋病毒全国调查中获得了关于艾滋病毒阴谋信念流行率和相关性的最新数据，这是一项对868名18-50岁黑人的全国代表性电子邮件调查（2016年2月至4月）。相当多的人认为艾滋病毒是人为的（31%），政府拒绝治疗艾滋病毒（40%）。艾滋病毒阴谋信念和艾滋病毒风险都与较高的艾滋病毒检测可能性显着相关。艾滋病毒阴谋信念和艾滋病毒检测之间的关联显着介导的个人水平的艾滋病毒风险（总效应的73%），但不是由地区一级的社会经济地位（较高的艾滋病毒流行率的生态决定因素）。不信任在美国黑人中仍然很高，但不信任与预防行为的关联是复杂的。不信任公共卫生系统的人也可能面临更大的风险，因此更有可能接受检测，这可能是因为更容易进入涉及高风险人群的社区检测场所。
Black Americans are greatly affected by HIV disparities and exhibit high levels of medical mistrust, including HIV conspiracy beliefs, a form of mistrust around HIV's origin and treatment. A 2002-2003 national survey of Black Americans found that 48% believed that "HIV is a manmade virus." However, the extent to which such beliefs remain widespread is unknown. Moreover, HIV conspiracy beliefs have been associated with greater HIV risk, but have also been associated with a higher testing likelihood-and no research to date has attempted to explain these seemingly contradictory findings. We obtained updated data on prevalence and correlates of HIV conspiracy beliefs from the US National Survey on HIV in the Black Community, a nationally representative e-mail survey of 868 Black individuals aged 18-50 years (February-April 2016). Substantial percentages agreed that HIV is man-made (31%) and that the government is withholding a cure for HIV (40%). HIV conspiracy beliefs and HIV risk were both significantly associated with a higher HIV testing likelihood. The association between HIV conspiracy beliefs and HIV testing was significantly mediated by individual-level HIV risk (73% of total effect), but not by area-level socioeconomic position (an ecological determinant of higher HIV prevalence). Mistrust remains high among Black Americans, but the association of mistrust with prevention behaviors is complex. People who do not trust the public health system may also be at greater risk-and thus, more likely to get tested, potentially due to greater access to community-based testing venues that engage higher risk populations.