COVID-19 Related Medical Mistrust, Health Impacts, and Potential Vaccine Hesitancy Among Black Americans Living With HIV
| Autor: | Keshav Tyagi, Bisola O. Ojikutu, Matt G. Mutchler, David J. Klein, Laura M. Bogart, Sarah Kellman, Sean Jamar Lawrence, Lu Dong, Damone R. Thomas |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Government
medicine.medical_specialty Social work business.industry media_common.quotation_subject MEDLINE Racism law.invention Sexual minority Infectious Diseases Randomized controlled trial law Intervention (counseling) Family medicine Health care Medicine Pharmacology (medical) business media_common |
| Zdroj: | JAIDS Journal of Acquired Immune Deficiency Syndromes |
| ISSN: | 1525-4135 |
| DOI: | 10.1097/qai.0000000000002570 |
| Popis: | BACKGROUND Medical mistrust, a result of systemic racism, is prevalent among Black Americans and may play a role in COVID-19 inequities. In a convenience sample of HIV-positive Black Americans, we examined associations of COVID-19-related medical mistrust with COVID-19 vaccine and COVID-19 treatment hesitancy and negative impacts of COVID-19 on antiretroviral therapy (ART) adherence. METHODS Participants were 101 HIV-positive Black Americans (age: M = 50.3 years; SD = 11.5; 86% cisgender men; 77% sexual minority) enrolled in a randomized controlled trial of a community-based ART adherence intervention in Los Angeles County, CA. From May to July 2020, participants completed telephone interviews on negative COVID-19 impacts, general COVID-19 mistrust (eg, about the government withholding information), COVID-19 vaccine and treatment hesitancy, and trust in COVID-19 information sources. Adherence was monitored electronically with the Medication Event Monitoring System. RESULTS Nearly all participants (97%) endorsed at least one general COVID-19 mistrust belief, and more than half endorsed at least one COVID-19 vaccine or treatment hesitancy belief. Social service and health care providers were the most trusted sources. Greater COVID-19 mistrust was related to greater vaccine and treatment hesitancy [b (SE) = 0.85 (0.14), P < 0.0001 and b (SE) = 0.88 (0.14), P < 0.0001, respectively]. Participants experiencing more negative COVID-19 impacts showed lower ART adherence, assessed among a subset of 49 participants [b (SE) = -5.19 (2.08), P = 0.02]. DISCUSSION To prevent widening health inequities, health care providers should engage with communities to tailor strategies to overcome mistrust and deliver evidence-based information, to encourage COVID-19 vaccine and treatment uptake. |
| Databáze: | OpenAIRE |
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