Cunningham C O, Sohler N L, Korin L, Gao W, Anastos K
Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York 10467, USA.
AIDS Care. 2007 Feb;19(2):226-34. doi: 10.1080/09540120600774263.
Trust in health care providers and the health care system are essential. This study examined factors associated with trust in providers and distrust in the health care system among minority HIV-positive and -negative women. Interviews were conducted and laboratory tests performed with 102 women from the Women's Interagency HIV Study Bronx site. Interviews collected information about trust in providers, distrust in the system, substance use, mental health symptoms and medications, and sociodemographic characteristics. Many reported distrust of the health care system related to HIV, and most reported trust in their providers. On linear regression analyses, characteristics associated with distrust in the health care system included depressive symptoms (beta=0.48, p<0.05). Characteristics associated with trust in providers included HIV-positive status (beta=0.35, p<0.05), taking mental health medications (beta=0.39, p<0.05), and having a white provider (beta=0.36, p<0.05). Despite distrust in the health care system related to HIV, most reported high trust in their providers, with HIV-positive women trusting their providers more than HIV-negative women. Studies are needed to understand how trust in providers and the health care system is achieved and maintained, and how trust is correlated with HIV-related health outcomes.
信任医疗服务提供者和医疗保健系统至关重要。本研究调查了少数族裔艾滋病毒阳性和阴性女性中与对医疗服务提供者的信任以及对医疗保健系统的不信任相关的因素。对来自布朗克斯区妇女机构间艾滋病毒研究站点的102名女性进行了访谈并进行了实验室测试。访谈收集了有关对医疗服务提供者的信任、对系统的不信任、药物使用、心理健康症状和药物以及社会人口统计学特征的信息。许多人报告对与艾滋病毒相关的医疗保健系统不信任,而大多数人报告信任他们的医疗服务提供者。在线性回归分析中,与对医疗保健系统的不信任相关的特征包括抑郁症状(β=0.48,p<0.05)。与对医疗服务提供者的信任相关的特征包括艾滋病毒阳性状态(β=0.35,p<0.05)、服用心理健康药物(β=0.39,p<0.05)以及有白人医疗服务提供者(β=0.36,p<0.05)。尽管对与艾滋病毒相关的医疗保健系统不信任,但大多数人报告对他们的医疗服务提供者高度信任,艾滋病毒阳性女性比艾滋病毒阴性女性更信任她们的医疗服务提供者。需要开展研究以了解如何实现和维持对医疗服务提供者和医疗保健系统的信任,以及信任如何与艾滋病毒相关的健康结果相关联。