Department of Epidemiology and Biostatistics, Michigan State University, 909 Wilson Road, East Lansing, MI, USA.
Department of Sociomedical Sciences, Columbia University, New York, NY, USA.
AIDS Behav. 2019 Oct;23(10):2859-2869. doi: 10.1007/s10461-019-02464-1.
Medical mistrust is an important risk factor for many health outcomes. For individuals with HIV and substance use co-morbidities, mistrust may influence engagement with health care, and affect overall health and transmission risk. Medical mistrust can be measured by an individual's mistrust of his/her physician, or mistrust of the medical system. This study examined both types of mistrust among 801 substance-using individuals with uncontrolled HIV infection. The aims were to determine how physician mistrust, medical system mistrust, and discrimination experiences were associated with engagement in HIV primary care. Findings indicated higher levels of physician mistrust, but not medical system mistrust, were associated with a longer time since the last visit to an HIV provider. Longer time since seeing an HIV care provider was associated with higher viral load. This study refines our understanding of the relationship between mistrust and HIV care engagement for a large, diverse sample of substance-using individuals.
医学不信任是许多健康结果的一个重要风险因素。对于同时患有 HIV 和物质使用共病的个体，不信任可能会影响他们对医疗保健的参与，并影响整体健康和传播风险。医学不信任可以通过个体对医生的不信任或对医疗系统的不信任来衡量。本研究在 801 名患有未控制 HIV 感染的物质使用个体中检查了这两种类型的不信任。目的是确定医生不信任、医疗系统不信任和歧视经历与 HIV 初级保健的参与程度有何关联。研究结果表明，与最后一次看 HIV 提供者的时间相比，更高水平的医生不信任，但不是医疗系统的不信任，与更长的时间相关。与 HIV 护理提供者见面的时间越长，病毒载量越高。这项研究深化了我们对大量不同的物质使用个体中不信任与 HIV 护理参与之间关系的理解。
