Department of Health Science, University of Alabama, Tuscaloosa, Alabama, USA.
Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, Connecticut, USA.
LGBT Health. 2023 Aug-Sep;10(6):471-479. doi: 10.1089/lgbt.2022.0252. Epub 2023 Jul 7.
Medical mistrust is a barrier to health care utilization and is associated with suboptimal health outcomes. Research on mistrust among sexual minority men (SMM) is limited and largely focuses on Black SMM and HIV, with few studies assessing mistrust among SMM of other race/ethnicities. The purpose of this study was to examine differences in medical mistrust among SMM by race. From February 2018 to February 2019, a mixed-methods study examined the health-related beliefs and experiences of young SMM in New York City. The Group-Based Medical Mistrust Scale (GBMMS) was used to measure medical mistrust related to race, and a modified version of the scale assessed mistrust related to one's "sexual/gender minority" status (Group-Based Medical Mistrust Scale-Sexual/Gender Minority [GBMMS-SGM]). With an analytic sample of 183 cisgender SMM, a one-way multivariate analysis of variance was used to examine differences in GBMMS and GBMMS-SGM scores by race/ethnicity [Black, Latinx, White, "Another Racial Group(s)"]. There were significantly different GBMMS scores by race, with participants of color reporting higher levels of race-based medical mistrust than White participants. This finding is supported by effect sizes ranging from moderate to large. Differences in GBMMS-SGM scores by race were borderline; however, the effect size for Black and White participants' GBMMS-SGM scores was moderate, indicating that higher GBMMS-SGM scores among Black participants is meaningful. Multilevel strategies should be used to earn the trust of minoritized populations, such as addressing both historical and ongoing discrimination, moving beyond implicit bias trainings, and strengthening the recruitment and retention of minoritized health care professionals.
医学不信任是利用医疗保健的障碍，并且与健康结果不理想有关。针对性少数群体男性（SMM）的不信任研究有限，主要集中在黑人 SMM 和 HIV 上，很少有研究评估其他种族/族裔的 SMM 的不信任。本研究的目的是检查不同种族的 SMM 之间的医学不信任差异。
从 2018 年 2 月至 2019 年 2 月，一项混合方法研究调查了纽约市年轻 SMM 的健康相关信仰和经验。使用基于群体的医学不信任量表（GBMMS）来衡量与种族有关的医学不信任，以及量表的一个修改版本来衡量与一个人的“性/性别少数”身份有关的不信任（基于群体的医学不信任量表-性/性别少数[GBMMS-SGM]）。在一个分析样本中，有 183 名顺性别 SMM，使用单向多元方差分析来检查种族/族裔之间的 GBMMS 和 GBMMS-SGM 分数的差异[黑人，拉丁裔，白人，“其他种族群体”]。
种族之间的 GBMMS 分数存在显着差异，有色人种参与者报告的基于种族的医学不信任程度高于白人参与者。这种发现得到了从中等到较大的效应大小的支持。种族之间的 GBMMS-SGM 分数差异处于边缘状态；然而，黑人和白人参与者的 GBMMS-SGM 分数的效应大小适中，表明黑人参与者的 GBMMS-SGM 分数较高是有意义的。
应该使用多层次策略来赢得少数群体的信任，例如解决历史和持续的歧视，超越隐含偏见培训，并加强少数族裔医疗保健专业人员的招聘和保留。
