Yale University

The Role of Stigma and Medical Mistrust in the Routine Health Care Engagement of Black Men Who Have Sex With Men.

TitleThe Role of Stigma and Medical Mistrust in the Routine Health Care Engagement of Black Men Who Have Sex With Men.
Publication TypeJournal Article
Year of Publication2014
AuthorsEaton, Lisa A., Daniel D. Driffin, Christopher Kegler, Harlan Smith, Christopher Conway-Washington, Denise White, and Chauncey Cherry
JournalAmerican journal of public health
Paginatione1-e8
Date Published2014 Dec 18
ISSN1541-0048
AbstractObjectives. 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. (Am J Public Health. Published online ahead of print December 18, 2014: e1-e8. doi:10.2105/AJPH.2014.302322).
DOI10.2105/AJPH.2014.302322
Alternate JournalAm J Public Health

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