Discrimination, Distrust, and Racial/Ethnic Disparities in Antiretroviral Therapy Adherence Among a National Sample of HIV-Infected Patients

Simple item page
dc.contributor.authorThrasher, Angela D.
dc.contributor.authorEarp, Jo Anne L.
dc.contributor.authorGolin, Carol E.
dc.contributor.authorZimmer, Catherine R.
dc.date.accessioned2019-08-14T15:01:29Z
dc.date.available2019-08-14T15:01:29Z
dc.date.issued2008
dc.description.abstractObjective: Although discriminatory health care experiences and health care provider distrust have been shown to be associated with health care disparities, little is known about their contribution to racial/ethnic disparities in antiretroviral therapy adherence. We therefore sought to assess the extent to which discriminatory health care experiences and health care provider distrust influence treatmentrelated attitudes, beliefs, and self-reported adherence in a national sample of HIV-infected patients. Study Design: This secondary analysis used data from the HIV Cost and Services Utilization Study. We used structural equation modeling to identify pathways from minority status to adherence through discrimination, distrust, and treatment-related attitudes and beliefs. Participants: The sample was the 1886 participants who completed the baseline and 2 follow-up interviews and were prescribed antiretroviral therapy at the second follow-up interview (54% white, 28% black, 14% Hispanic, and 3% others). Results: Minorities were less likely to report perfect adherence than whites (40% vs. 50%, P # 0.001). Over one third (40%) of all participants reporting ever having discriminatory health care experiences since having HIV, and 24% did not completely or almost completely trust their health care providers. The effect of minority status on adherence persisted in the full model. More discrimination predicted greater distrust, weaker treatment benefit beliefs, and, in turn, poorer adherence. Distrust affected adherence by increasing treatment-related psychological distress and weakening treatment benefit beliefs. Conclusions: The relationship between minority status and adherence was not fully explained by patient-level factors. Future studies should consider conceptualizing minority status as a contextual factor rather than predictor.
dc.description.urihttp://journals.lww.com/jaids/fulltext/2008/09010/discrimination,_distrust,_and_racial_ethnic.13.aspx
dc.identifierhttps://doi.org/10.13016/vgbt-pbor
dc.identifier.citationThrasher, Angela D. and Earp, Jo Anne L. and Golin, Carol E. and Zimmer, Catherine R. (2008) Discrimination, Distrust, and Racial/Ethnic Disparities in Antiretroviral Therapy Adherence Among a National Sample of HIV-Infected Patients. Journal of Acquired Immune Deficiency Syndromes, 49 (1). pp. 84-93.
dc.identifier.otherEprint ID 1059
dc.identifier.urihttp://hdl.handle.net/1903/23007
dc.subjectResearch
dc.subjectChronic Illness & Diseases
dc.subjectStress
dc.subjectDisparities
dc.subjectHealth
dc.subjectHealth Risk Factors
dc.subjectstudies
dc.subjectmethodologies
dc.subjectPublic Health
dc.subjectHIV/Aids
dc.subjectAccess To Healthcare
dc.subjectHealth Equity
dc.subjectantiretroviral therapy
dc.subjectadherence
dc.subjectdisparities
dc.subjectrace/ethnicity
dc.titleDiscrimination, Distrust, and Racial/Ethnic Disparities in Antiretroviral Therapy Adherence Among a National Sample of HIV-Infected Patients
dc.typeArticle

Files

Collections

Minority Health and Health Equity Archive