Racial/Ethnic Differences in Trust in Health Care: HIV Conspiracy Beliefs and Vaccine Research Participation
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Prior research has documented a high prevalence of conspiracy beliefs about the origin of the human immunodeficiency virus (HIV) and the role of the government in the acquired immunodeficiency syndrome (AIDS) epidemic, particularly among racial and ethnic minorities in the United States. Whether such beliefs are a barrier to participation in HIV prevention research is not known.
To understand the prevalence of HIV conspiracy beliefs and their relationship to willingness to participate in HIV vaccine research among three racial/ethnic groups.
Six hundred and one community-recruited volunteers (33.0 % White, 32.5 % Mexican American, and 34.5 % African American).
We evaluated the level of agreement with six previously described HIV conspiracy beliefs, trust in medical research, and willingness to participate in HIV vaccine research. Multivariate models were used to compare these parameters among the three racial/ethnic groups while controlling for the potential confounding effects of socioeconomic status, access to health care, and other demographic factors.
African Americans, Mexican Americans, and whites had similar levels of distrust in medical research. African and Mexican Americans were more likely to endorse one or more of six HIV conspiracy beliefs than whites (59.0 % and 58.6 % versus 38.9 %, respectively, P < 0.001), but were significantly more willing to participate in HIV vaccine research (ORs 1.58, CI 1.10–2.25 and 2.53, CI 1.75–3.66, respectively). Among respondents of all racial/ethnic groups, endorsing HIV conspiracy beliefs was not associated with willingness to participate in research.
HIV conspiracy beliefs, while common among all racial and ethnic groups in the United States, do not preclude willingness to participate in HIV prevention research.
- Centers for Disease Control and Prevention. Racial/ethnic disparities in diagnoses of HIV/AIDS—33 states, 2001–2004. MMWR Morb Mortal Wkly Rep. 2006;55(5):121–125.
- Centers for Disease Control and Prevention. Racial/ethnic disparities in diagnoses of HIV/AIDS—33 states, 2001–2005. MMWR Morb Mortal Wkly Rep. 2007;56(9):189–193.
- Centers for Disease Control & Prevention. HIV Surveillance Report, 2010. Vol. 22. http://www.cdc.gov/hiv/library/reports/surveillance/2010/surveillance_Report_vol_22. Published March 2012. Accessed 07/01/13.
- Linley L, Prejean J, An Q, Chen M, Hall HI. Racial/ethnic disparities in hiv diagnoses among persons aged 50 years and older in 37 US States, 2005–2008. Am J Public Health. 2012;102(8):1527–1534. CrossRef
- McDavid K, Li J, Lee LM. Racial and ethnic disparities in HIV diagnoses for women in the United States. J Acquir Immune Defic Syndr. 2006;42(1):101–107. CrossRef
- Hall HI, Byers RH, Ling Q, Espinoza L. Racial/ethnic and age disparities in HIV prevalence and disease progression among men who have sex with men in the United States. Am J Public Health. 2007;97(6):1060–1066. CrossRef
- Millett GA, Peterson JL, Flores SA, et al. Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis. Lancet. 2012;380(9839):341–348. CrossRef
- Yehia BR, Fleishman JA, Metlay JP, et al. Comparing different measures of retention in outpatient HIV care. AIDS. 2012;26(9):1131–1139. CrossRef
- Fleishman JA, Yehia BR, Moore RD, Korthuis PT, Gebo KA. Establishment, retention, and loss to follow-up in outpatient HIV care. J Acquir Immune Defic Syndr. 2012;60(3):249–259.
- Yehia BR, Fleishman JA, Metlay JP, Moore RD, Gebo KA. Sustained viral suppression in HIV-infected patients receiving antiretroviral therapy. JAMA. 2012;308(4):339–342. CrossRef
- Giordano TP, Bartsch G, Zhang Y, et al. Disparities in outcomes for African American and Latino subjects in the Flexible Initial Retrovirus Suppressive Therapies (FIRST) trial. AIDS Patient Care STDS. 2010;24(5):287–295.
- Mugavero MJ, Lin HY, Allison JJ, et al. Racial disparities in HIV virologic failure: do missed visits matter? J Acquir Immune Defic Syndr. 2009;50(1):100–108. CrossRef
- Gifford AL, Cunningham WE, Heslin KC, et al. Participation in research and access to experimental treatments by HIV-infected patients. N Engl J Med. 2002;346(18):1373–1382. CrossRef
- Stone VE, Mauch MY, Steger K, Janas SF, Craven DE. Race, gender, drug use, and participation in AIDS clinical trials. Lessons from a municipal hospital cohort. J Gen Intern Med Mar. 1997;12(3):150–157.
- Gamble VN. Under the shadow of Tuskegee: African Americans and health care. Am J Public Health. 1997;87(11):1773–1778. CrossRef
- Gamble VN. The Tuskegee Syphilis study and women’s health. J Am Med Women’s Assoc. 1997;52(4):195–196.
- Braunstein JB, Sherber NS, Schulman SP, Ding EL, Powe NR. Race, medical researcher distrust, perceived harm, and willingness to participate in cardiovascular prevention trials. Medicine. 2008;87(1):1–9. CrossRef
- Harris Y, Gorelick PB, Samuels P, Bempong I. Why African Americans may not be participating in clinical trials. J Natl Med Assoc. 1996;88(10):630–634.
- Mouton CP, Harris S, Rovi S, Solorzano P, Johnson MS. Barriers to black women’s participation in cancer clinical trials. J Natl Med Assoc. 1997;89(11):721–727.
- Shavers VL, Lynch CF, Burmeister LF. Racial differences in factors that influence the willingness to participate in medical research studies. Ann Epidemiol. 2002;12(4):248–256. CrossRef
- Gorelick PB, Harris Y, Burnett B, Bonecutter FJ. The recruitment triangle: reasons why African Americans enroll, refuse to enroll, or voluntarily withdraw from a clinical trial. An interim report from the African-American Antiplatelet Stroke Prevention Study (AAASPS). J Natl Med Assoc. 1998;90(3):141–145.
- Volkmann ER, Claiborne D, Currier JS. Determinants of participation in HIV clinical trials: the importance of patients’ trust in their provider. HIV Clin Trials. 2009;10(2):104–109. CrossRef
- Sengupta S, Strauss RP, DeVellis R, Quinn SC, DeVellis B, Ware WB. Factors affecting African-American participation in AIDS research. J Acquir Immune Defic Syndr. 2000;24(3):275–284.
- Jones JH. Bad blood: the Tuskegee Syphilis experiment. New and expanded edition. New York: Te Free Press; 1993.
- Klonoff EA, Landrine H. Do blacks believe that HIV/AIDS is a government conspiracy against them? Prev Med. 1999;28(5):451–457. CrossRef
- Herek GM, Capitanio JP. Conspiracies, contagion, and compassion: trust and public reactions to AIDS. AIDS Educ Prev. 1994;6(4):365–375.
- Bogart LM, Thorburn S. Are HIV/AIDS conspiracy beliefs a barrier to HIV prevention among African Americans? J Acquir Immune Defic Syndr. 2005;38(2):213–218. CrossRef
- Ross MW, Essien EJ, Torres I. Conspiracy beliefs about the origin of HIV/AIDS in four racial/ethnic groups. J Acquir Immune Defic Syndr. 2006;41(3):342–344. CrossRef
- Bogart LM, Wagner G, Galvan FH, Banks D. Conspiracy beliefs about HIV are related to antiretroviral treatment nonadherence among African American men with HIV. J Acquir Immune Defic Syndr. 2010;53(5):648–655.
- Clark A, Mayben JK, Hartman C, Kallen MA, Giordano TP. Conspiracy beliefs about HIV infection are common but not associated with delayed diagnosis or adherence to care. AIDS Patient Care STDS. 2008;22(9):753–759. CrossRef
- Bogart LM, Galvan FH, Wagner GJ, Klein DJ. Longitudinal association of HIV conspiracy beliefs with sexual risk among black males living with HIV. AIDS Behav. 2011;15(6):1180–1186. CrossRef
- Gray R, Kigozi G, Kong X, et al. The effectiveness of male circumcision for HIV prevention and effects on risk behaviors in a posttrial follow-up study. AIDS. 2012;26(5):609–615. CrossRef
- Gray RH, Kigozi G, Serwadda D, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369(9562):657–666. CrossRef
- Abdool Karim Q, Abdool Karim SS, Frohlich JA, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329(5996):1168–1174. CrossRef
- Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–2599. CrossRef
- Baeten JM, Donnell D, Ndase P, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367(5):399–410. CrossRef
- Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 Infection with Early Antiretroviral Therapy. N Eng J Med. 2011;0(0).
- Johnston MI, Fauci AS. HIV vaccine development–improving on natural immunity. N Engl J Med. 2011;365(10):873–875. CrossRef
- Hall MA, Camacho F, Lawlor JS, Depuy V, Sugarman J, Weinfurt K. Measuring trust in medical researchers. Med Care. 2006;44(11):1048–1053. CrossRef
- Bogart LM, Thorburn S. Relationship of African Americans’ sociodemographic characteristics to belief in conspiracies about HIV/AIDS and birth control. J Natl Med Assoc. 2006;98(7):1144–1150.
- Prejean J, Song R, Hernandez A, et al. Estimated HIV Incidence in the United States, 2006–2009. PLoS One. 2011;6(8):e17502. CrossRef
- Garber M, Hanusa BH, Switzer GE, Mellors J, Arnold RM. HIV-infected African Americans are willing to participate in HIV treatment trials. J Gen Intern Med. 2007;22(1):17–42. CrossRef
- Adeyemi OF, Evans AT, Bahk M. HIV-infected adults from minority ethnic groups are willing to participate in research if asked. AIDS Patient Care STDS. 2009;23(10):859–865. CrossRef
- Wendler D, Kington R, Madans J, et al. Are racial and ethnic minorities less willing to participate in health research? PLoS Med. 2006;3(2):e19. CrossRef
- Newman PA, Duan N, Rudy ET, Roberts KJ, Swendeman D. Posttrial HIV vaccine adoption: concerns, motivators, and intentions among persons at risk for HIV. J Acquir Immune Defic Syndr. 2004;37(3):1393–1403. CrossRef
- Newman PA, Duan N, Roberts KJ, et al. HIV vaccine trial participation among ethnic minority communities: barriers, motivators, and implications for recruitment. J Acquir Immune Defic Syndr. 2006;41(2):210–217. CrossRef
- Racial/Ethnic Differences in Trust in Health Care: HIV Conspiracy Beliefs and Vaccine Research Participation
Journal of General Internal Medicine
Volume 29, Issue 1 , pp 140-146
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- trust in health care
- HIV vaccine research
- conspiracy beliefs
- Industry Sectors
- Author Affiliations
- 1. Departments of Medicine & Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 1685 Highland Ave, MFCB 5220, Madison, WI, 53705, USA
- 2. Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
- 3. Section of General Internal Medicine, Portland VA Medical Center, Portland, OR, USA
- 4. The Health Innovation Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA