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

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  • Eaton, L.A.
  • Driffin, D.D.
  • Kegler, C.
  • Smith, H.
  • Conway-Washington, C.
  • White, D.
  • Cherry, C.

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.

Suggested Citation

  • Eaton, L.A. & Driffin, D.D. & Kegler, C. & Smith, H. & Conway-Washington, C. & White, D. & Cherry, C., 2015. "The role of stigma and medical mistrust in the routine health care engagement of black men who have sex with men," American Journal of Public Health, American Public Health Association, vol. 105(2), pages 75-82.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2014.302322_7
    DOI: 10.2105/AJPH.2014.302322
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    Cited by:

    1. Shoshana Y Kahana & Richard A Jenkins & Douglas Bruce & Maria I Fernandez & Lisa B Hightow-Weidman & Jose A Bauermeister & Adolescent Medicine Trials Network for HIV/AIDS Interventions, 2016. "Structural Determinants of Antiretroviral Therapy Use, HIV Care Attendance, and Viral Suppression among Adolescents and Young Adults Living with HIV," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-19, April.
    2. Shauna Stahlman & Ashley Grosso & Sosthenes Ketende & Vincent Pitche & Seni Kouanda & Nuha Ceesay & Henri G Ouedraogo & Odette Ky-Zerbo & Marcel Lougue & Daouda Diouf & Simplice Anato & Jules Tchalla , 2016. "Suicidal ideation among MSM in three West African countries: Associations with stigma and social capital," International Journal of Social Psychiatry, , vol. 62(6), pages 522-531, September.
    3. Salabarría-Peña, Yamir & Robinson, William T., 2022. "Going beyond performance measures in HIV-prevention: A funder-recipient expedition," Evaluation and Program Planning, Elsevier, vol. 90(C).
    4. Mark Henrickson & Meaghan Fisher, 2016. "‘Treating Africans differently’: using skin colour as proxy for HIV risk," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(13-14), pages 1941-1949, July.
    5. Long, Amanda & Jennings, Jacky & Bademosi, Kehinde & Chandran, Aruna & Sawyer, Simone & Schumacher, Christina & Greenbaum, Adena & Fields, Errol L., 2022. "Storytelling to improve healthcare worker understanding, beliefs, and practices related to LGBTQ + patients: A program evaluation," Evaluation and Program Planning, Elsevier, vol. 90(C).
    6. Madina Agénor & J. Wyatt Koma & Ashley E. Pérez & Alex McDowell & Gilbert Gonzales, 2023. "Differences in Health Insurance and Usual Source of Care Among Racial/Ethnic and Sexual Orientation Subgroups of U.S. Women and Men," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(3), pages 1-26, June.
    7. Ofole Mgbako & Magdalena E. Sobieszczyk & Susan Olender & Peter Gordon & Jason Zucker & Susan Tross & Delivette Castor & Robert H. Remien, 2020. "Immediate Antiretroviral Therapy: The Need for a Health Equity Approach," IJERPH, MDPI, vol. 17(19), pages 1-10, October.
    8. Chadwick K. Campbell & Kirstin Kielhold & Hannah E. Reynolds & Wilson Vincent & Daniel E. Siconolfi & Stephen D. Ramos & Adedotun Ogunbajo & Susan M. Kegeles & Erik D. Storholm, 2024. "LAI-ART Awareness, Willingness, Barriers and Facilitators among Black Sexual Minority Men Living with HIV in the US South," IJERPH, MDPI, vol. 21(5), pages 1-13, May.
    9. Yen-Ju Lin & Yu-Ping Chang & Wen-Jiun Chou & Cheng-Fang Yen, 2021. "Explicit and Intrinsic Intention to Receive COVID-19 Vaccination among Heterosexuals and Sexual Minorities in Taiwan," IJERPH, MDPI, vol. 18(14), pages 1-10, July.
    10. Frye, Victoria & Paige, Mark Q. & Gordon, Steven & Matthews, David & Musgrave, Geneva & Kornegay, Mark & Greene, Emily & Phelan, Jo C. & Koblin, Beryl A. & Taylor-Akutagawa, Vaughn, 2017. "Developing a community-level anti-HIV/AIDS stigma and homophobia intervention in new York city: The project CHHANGE model," Evaluation and Program Planning, Elsevier, vol. 63(C), pages 45-53.
    11. Carter, Jarvis W. & Salabarría-Peña, Yamir & Fields, Errol L. & Robinson, William T., 2022. "Evaluating for health equity among a cluster of health departments implementing PrEP services," Evaluation and Program Planning, Elsevier, vol. 90(C).
    12. Yusen Zhai & Kyesha M. Isadore & Lauren Parker & Jeremy Sandberg, 2023. "Responding to the HIV Health Literacy Needs of Clients in Substance Use Treatment: The Role of Universal PrEP Education in HIV Health and Prevention," IJERPH, MDPI, vol. 20(19), pages 1-19, October.
    13. Salabarría-Peña, Yamir & Douglas, Chelsea & Brantley, Meredith & Johnson, Amy K., 2022. "Informing the future of PrEP navigation: Findings from a five-site cluster evaluation," Evaluation and Program Planning, Elsevier, vol. 90(C).

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