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Race-Based Medical Mistrust, HIV-Related Stigma, and ART Adherence in a Diverse Sample of Men Who Have Sex with Men with HIV

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Abstract

Disparities in antiretroviral treatment (ART) access by race for men who have sex with men (MSM) with HIV persist. We assessed whether race-based medical mistrust and HIV stigma impact ART adherence among MSM with HIV. Longitudinal data were drawn from a RCT of a messaging intervention to promote sexual health among MSM. Regression models tested associations between baseline race-based medical mistrust, HIV stigma, and ART adherence at follow-up. In multivariable models with the overall sample of MSM with HIV (n = 383), baseline medical mistrust was negatively associated with ART adherence 3-months post-baseline. Among participants of color (i.e., Black/African American, Hispanic/Latino, or another race; n = 301), HIV stigma was negatively associated with optimal ART adherence 6-months post-baseline. Medical mistrust was longitudinally associated with reduced ART adherence among racially and ethnically diverse MSM with HIV. HIV-related services might prioritize patients reporting medical mistrust for additional supports.

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Data Availability

The datasets generated and analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Acknowledgements

We thank all M3 study participants for their willingness to participate, and all study staff for their support. The M3 study was funded by CDC cooperative agreement #U01PS004977. Keith Horvath and Stephanie Meyers-Pantele were supported through NIDA grant R01 DA039950. Stephanie Meyers-Pantele was also supported by NIDA grant T32 DA023356. This work was supported by the Center for AIDS Research at Emory University (P30AI050409).

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Funding

The M3 study was funded by CDC Cooperative Agreement #U01PS004977. Keith Horvath and Stephanie Meyers-Pantele were supported through NIDA Grant R01 DA039950 and Stephanie Meyers-Pantele was further supported through NIDA Grant T32 DA 023356. This work was supported by the Center for AIDS Research at Emory University (P30AI050409).

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Authors and Affiliations

  1. Department of Psychology, San Diego State University, San Diego, CA, USA

    Stephanie A. Meyers-Pantele & Keith J. Horvath

  2. Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Patrick Sullivan

  3. Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Gordon Mansergh

  4. Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA

    Sabina Hirshfield

  5. The Center for Sexuality and Health Disparities and the School of Nursing, University of Michigan, Ann Arbor, MI, USA

    Rob Stephenson

  6. Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA

    Stephanie A. Meyers-Pantele

Authors
  1. Stephanie A. Meyers-Pantele
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  2. Patrick Sullivan
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  4. Sabina Hirshfield
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  5. Rob Stephenson
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  6. Keith J. Horvath
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Contributions

SM-P: Conceptualization, Formal Analysis, Writing—Original Draft Preparation. PS: Conceptualization, Investigation, Resources, Funding Acquisition, and Writing—Reviewing and Editing. GM: Conceptualization, Methodology, Resources, Funding Acquisition, and Writing—Reviewing and Editing. SH: Conceptualization and Writing—Reviewing and Editing. RS: Conceptualization and Writing—Reviewing and Editing. KH: Conceptualization, Methodology, Resources, Supervision, Funding Acquisition, and Writing—Reviewing and Editing.

Corresponding author

Correspondence to Stephanie A. Meyers-Pantele.

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The authors declare that they have no conflicts of interest.

Ethical Approval

Study protocols and intervention materials were approved by the Emory University Institutional Review Board.

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All study participants provided informed consent prior to enrollment.

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Meyers-Pantele, S.A., Sullivan, P., Mansergh, G. et al. Race-Based Medical Mistrust, HIV-Related Stigma, and ART Adherence in a Diverse Sample of Men Who Have Sex with Men with HIV. AIDS Behav 26, 1456–1466 (2022). https://doi.org/10.1007/s10461-021-03500-9

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  • DOI: https://doi.org/10.1007/s10461-021-03500-9

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