Open AccessPhysician Mistrust, Medical System Mistrust, and Perceived Discrimination: Associations with HIV Care Engagement and Viral Load
Author(s) -
Ahnalee M. Brincks,
Karen ShiuYee,
Lisa R. Metsch,
Carlos del Rı́o,
Robert P. Schwartz,
Petra Jacobs,
Georgina Osorio,
James L. Sorensen,
Daniel J. Feaster
Publication year - 2019
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-019-02464-1
Subject(s) - health psychology , public health , health care , medicine , human immunodeficiency virus (hiv) , transmission (telecommunications) , viral load , family medicine , psychiatry , psychology , nursing , political science , electrical engineering , engineering , law
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.